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188139 DOHN CONSTRUCTION INC - INSURANCE CERTIFICATE (10)
DOHNCON-01 LWEISBRO ACkiOR� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/019 YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riqhts to the certificate holder in lieu of such endorsement(s). PRODUCER - - - PFS Insurance Group PHONE 4848 Thompson Parkway Suite 200 (AIC, No, Ext : (970) 635-9400 Johnstown, CO 80634 1 A��IEss: info@mypfsinsul INSURED Dohn Construction, Inc. DCI Residential, LLC 2642 Midpoint Drive Fort Collins, CO 80525 F: r-nVFRArl=c CFRTIFICATF NUMRFR- REVISION NUMBER: 635-9401 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOLINSD SUERWVD POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Blanket Add'I Insd 1R57255 10/1/2019 10/1/2020 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES (Ea o=rrence) $ 100,000 X MED EXP (Any oneperson) 6,000 X Blanket Waiver PERSONAL & ADV INJURY 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICY ❑X JECT LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS -COMPlOPAGG 2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUpTNOpSVyN p X ANS ONLY X AUTOS ONLY X Blanket Add'I Insd X Blanket Waiver 1Z57255 10/1/2019 10/1/2020 COMBINED SINGLE LIMIT 1,000,000 80DILY INJURY Perperson) BODILY INJURY Par accident PaQamldeT rt AMAGE A X I UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE 1PS7265 10M=19 10/1/2020 EACH OCCURRENCE $ 10,000,000 AGGREGATE 10,000,000 DED X I RETENTION$ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECIJTIVE Y❑ OF'RCERf'M EXCLUDED? (Mandatory n If yes. describe undor DESCRIPTION OF OPERATIONS below N/A 3056407 7M/2019 7M/2020 OTN- X PERST E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE III 1,000,000 E.L. DISEASE - POLICY LIMIT 1 000 000 A 'Installation Fit r 1067255 10/1/2019 10/1/2020 Limit 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it mom space is required) If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability. r`GDT!F!CATG HOLDER CANCFI I.ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPTION DATE THEREOF, ACCORDANCE WITH THEOCYY PROVISIONSCE WILL BE DELIVERED IN P.O. Box 580 Fort Collins, CO 80522 I AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD