HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (32)ACtC7RU� CERTIFICATE OF LIABILITY INSURANCE DAT10/03/2019 n�
10/03/2o1s _
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATEMOES NOT AFFIRMATIVELY OR NEGATIVELY AOEND, 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 poilcy(les) must have ADDITIONAL INSURED provisions or be endorsed:
H 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 rights to the certificate holder ip Ileu of such endorsement(s).
PRODUCER NCONTACT AME: BrianneDanielson, CISR
Flood and Peterson PHONE (970) 266.7119 FAX(AICNo):. (970) 506 6846
Corporate Mailing Address: ADDRESS. BOanielsonQRoodPeterson.com
P.O. Box 578 INSURE S AFFORDING COVERAGE NAIC 0
Greeley CO 80632 INSURERA, The Cincinnati Insurance Company _ 10677
Ditesco LLC INSURER C Certain Under"terS at UOydS, London 433U
2133 S Timberline Rd Unit 110 .INSURER D:
INSURER E :
Fort Collins CO 3052.54372 INSURER F:-
^^Il Mcn0e nen�ierrw :ufiuocc. C1191033177d oevreerniu uiiuneo. - - -
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
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY
BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS,
HAVE'. BEEN REDUCED BY PAID CLAIMS.
Lm
TYPE OF INSURANCE
INSO
WVVD
POLICY
NUMBER
MMn)
MMID
Levis
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$.1,000,000
CLAIMS -MADE ® OCCUR
PREMISES Eaaanence
E.. 1,000,000
MEDEXP oiw -
$ 10,000
A
Y
Y
ECP04583
7
10/03/2019
11/03/2019
PERSONAL$ AM INJURY
$ 1,000,000
GENL AGGREGATE LIMIT APPLIES PER
POLICY ❑ JET E LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS-COMPIOPAGG-
E. 2,000,000
OTHER
AUTOMOBILE LIABILITY
-
---
- -
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY(Perperson)
$
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Y
Y
EBA
7
10/03/2019
11/03/2019
BODILY INJURY (Per acciderlU
$
PROPERTY DAMAGE
Per amdem
$
Medical PaymeiAs
S 5,000
UMBRELLALULB
OCCUR
EACH OCCURRENCE-
$
AGGREGATE
$
EXCESS LIAO
CLAIMS -MADE
DED I I RETENTION E
$
B
WORKERS COMPENSATION
AND EMPLOYERS' uAsi rTY YIN
ANYPROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDEDT �
(Mandatory In NH)
NIA
Y
WC209762d212
03,15/2019
03/15/2020
PER
> - ER
EL EACH ACCIDENT . _
$ 1,000',000
I E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
EL. DISEASE - POLICY LIMIT
IT 1,000,000
If yes, describe urlder
DESCRIPTION OF OPERATIONS below
Each Claim
$1,000,000
C
Professional Liability
B0621POITI.
00118.
10/05/2018
11/03Y2019
Aggregate
$2,000,000
Retention
$10,000
DESCRIPTION OF OPERATIONS I LOCATIONS-1 VEHICLES (ACORD 101. Addhimal Rimarks
Project Mulberry Riverside Stone Drainage Project
The City of Fort Collins is included as Additional Insured as required by
Schedule, may be atluhed N rem space Is required)
n contract but only as respects to liability arising out of work performed by the
named insured. Waiver of subrogation applies.
�.,�.�,....�.,... eve I &AW&CI r A"nu
SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
700 Wood Street
AUTHORIZED REPRESENTATIVE
Fort Collins CO
80521
`%A1u4eAt a nwroilar
ril ler>pLV 1 V AI.VRY VVRrVRAI1Vre. Aa nBrum Inn uirvau.
ACORD 25 (2015(03) The ACORD name and logo are registered marks of ACORD