HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (33)CERTIFICATE
LIABILITY INSURANCE
DATE (MMIDDN YY)
CERTIFICATEDOES NOT AFFIRMATIVELY OR NEGATIVELY
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CC
REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
?ID, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
MUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
If SUBROGATION IS WAIVED, subject to the terms and condltl�ns of the policy, certain policies may require an endorsement. A statement on
this cerdfleste does not colder rights to the certificate holder 16 Neu of such endomement(s).
Flood and Paterson PHONE 0, (970) 2887119 1 AC Ns :. (970) 506-68M
Corporate Mailing Address: ADDRESS, BDanielson@RoodPeterson.com
P.O. Box 578 INSURER(S) AFFORDING COVERAGE NAZI
Greeley GO 1 1632 1NSORERA: The CIncin dtlInsuranceCompany 106
Ditesco LLC
2133 S Timberline Rd Unit 110
Fort Collins CO 60525-4372 I INSURER F :
COVERAGES CERTIFICATE NUMBER: I CL191033MII REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCELISTED 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 WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
BY THE POLICIES DESCRIBED HEREIN ISSUBJECT-TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY
HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
PO
CYNUMBER
POLICY EFF
MMODIYYYY
POLICY EXF
MMID
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE ®OCCUR
PREMISES "(Ea oo:urence
$ 11000-000
MED EXP one e
$ 10,000
A
-
Y
Y
ECP0456347
10/03/2019
11/03/2019
PERSONAL $AOVINJURY
$ 1,000,000
GENIAGGREGATE LIMIT APPLIES PER
GENERALAGGREGATE
S 2,000,000
PRO LOC
POLICY ❑
PRODUCTS-COWI&AGG
S 2,ODO,000
S
"
OTHER
AUTOMOBILELIABILITY
-
-_ - ___ _.
_
__.-
COMBINED SINGLE LIMIT
Ea accident)
-S 1,000,000
BODILY INJURY(Pwpenon)
$
ANY AUTO
A
OWNED SCHEOULED
AUTOS ONLY AUTOS
Y
Y
ESA 0458
7
10/03/2019
11/03/2019
BODILY INJURY(Pw accident)
$
P
Pmago
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Medical Payments
$ 5,000
UMBRELLA I"
OCCUR
EACH OCCURRENCE.
$
AGGREGATE.
$
EXCESS LIAR
.CLAIMS -MADE'
DIED RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
ANY PROPRIETORIPARTNER/EXECUTNE YIN
OFF10ERIMEMBFREXCLUDED? J
(Mandatory In NH)
NIA
I
WC2097624212
03/15/2019
03f15/2020
pp
PTATUTE ERA
E.L.EACH ACCIDENT
$_1,000,000
E.L. DISEASE - EA EMPLOYEE
_
$ 1,000,000
If Yes, deaedbe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 1,000,000
Each Claim
$1,000,000
C
Professional Lability
80621PD
00118
10/05/2018
11/03/2019
Aggregate
$2,000.000
Retention
$10.000
DESCRIPTION OF OPERATIONS / LOCATKIN3%VEHICLES (ACORD-1101, Addltlonal Itemarlo
Project: Sherwood Street Water Main Replacement
Schsdi le, may be aaaehed If awn span Is re hvd)
The City of Fort Collins is included as Additional Insured as required by
tten contract but only as respects to liability arising out of work performed by the
named insured. Waiver of subrogation applies.
CERTIFICATE HOLDER I CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED 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
— --- --
AUTIiORigD REPRESENTATIVE
Fort Collins CO
80521
`l34ldA�t !G.(fOM
®'19W2015ACORD CORPORATION. All rights reserved.
ACORD 25 (201&03) The ACORD q e and logo are registered marks of ACORD