HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (35)CERTIFICATE
LIABILITY INSURANCE I °"'
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 A END, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CON TITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
H
Flood and. Peterson
Corporate Mailing Address:
P.O. Box 578
Greeley CO
INSURED
Ditesco LLC
2133 S TImlledine Rd Unit 110
of the policy, certain policies may require an endorsement A statement on
(970)266-7119
The Continental Insurance Company
COVERAGES CERTIFICATE NUMBER: j OL191U33TTr4 REVISION NUMBER:
35289
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 SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR_
LTR
_
TYPE OF INSURANCE
�IJL
INSO
_..
POLICY
— - -
NUMBER _
MMN
MMM
.LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE-
E.
CLAIMS -MADE ® OCCUR
PREMISES Ea ettur,en
$ 1,000,000
MED EXP (Any onepoison)
$ 10,000
PERSONAL SADVINJURY
$ 1,000,0()0
A
Y
Y
ECP0456317
10/03/2019
11/03/2019
GENT AGGREGATE LIMITAPPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY 1:1; PRO.
D LOC
PRODUCTS-COMP/OP AGG
S. 2,000,000 --_ -
S
OTHER
AUTOMOBILE UpglLiTy
COMBINED BANGLE LIMIT
(Ea accident)
$ 1.000,000
ANY AUTO
BODILY INJURY(Pm pe )
S
A
OWNESCHEDULED
AUTOSD AUTOS
ONLY
Y
Y
EBA 045834
7
10/0312019
11/03/2019
BODILY INJURY (Per amwem)
S
PROPERTY DAMAGE_
S
HIRE° - NON -OWNED
AUTOS ONLY AUTOS ONLY
Per
_
Medical Payments
E 5,000
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
E
EXCESS LIAB
CLAIMS -MADE
DIED I I RETENTION $
S
WORKERS COMPENSATION
- -
-
.PER OTN-
AND EMPLOYERS' LIABILITY YIN
.STAT TE ER
E.L. EACH ACCIDENT
E 1,000,000 -1
B
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
NIA
Y
WC209762
212
03/15/2019
03/15/2020
E.L. DISEASE -. EA EMPLOYEE
S 1,000,000
(Mmtlatm I" N10
IfVyeas describe under
DESCRIPnON OF OPERATIONS below
E.L. DISEASE'- POLICY LIMIT
E 1,000.000
Each Claim
I $1,000,000
Professional Liability
C
80621PD
1X1118
10/0512018
11/03/2019
Aggregate
$2,000,000
i
Retention
$10.000
DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Addebntl 5tamarkf
9Madul0. my be ettxbad N morefpaef If npuNed)
Project: Water arid Wastwater CIP Funding Tool
The City of Fort Collins is, included as Additional Insured as required by
en contract but only as respects to liability arising out of work performed by the
named insured. Waiver of subrogation applies.
.CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BEOELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS. ..
700 Wood Street
AUTHORIZED REPRESENTATIVE
-
Fort Collins CC 180521
Y340K'On4A)ry
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2018f03) The ACORD name and logo are registered marks of ACORD