HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (36)ACCOROF CERTIFICATE OF LIABILITY INSURANCE """kMX"Wrrrrl
i 10ro3/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
TIF CERICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYA END, 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 H�LDER.
IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policles may require an endorsement A statement on
this certificate does not corder rights to the certificate holder In lieu of such endomement(s).
PRODUCER NAME: Brianne Danielson, CISR
Flood and Peterson PHONE (970)266-7119 Na: (970)506-6846
Corporate Mailing Address: ,ADDRESS: BDanielsoii@FlcodPetersort.6trh
P.O. BOX 578 INSURER(S)AFFORDING COVERAGE. _ NAIC 0
Greeley CO 80632 ,. mmm a • The Cincinnati Insurance Company -10677
INSURED
The
Dlieseo LLC INSURER C : Certain Underwriters at Lloyd's, London 43389
2133 S Timberline Rd Unit 110 INSURER D :
INSURER E :
Fort Collins CO 80525-4372 INSURER F: - -- - - -
r+^Cien.P.00 - ,+c�r�i+l uiruneia: ITJ1Q1nR3177d eian,zinu-ur isaeeo. -
THIS IS TO CER7IFY 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 ORMAY 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.
LTR
TYPE OF INSURANCE
N
POLICY
NUMBER
POLICY �f
MMIDDNM
POLICY EXP
MIDD
LIMBS
COMMERCIAL GENERAL LIABRM
EACH OCCURRENCE.
$ 1,000,000
CLAIMS -MADE OCCUR
I
PREMISES Ea oaunence
1,000,000
$ _
MEG EXP orm
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
A
Y
Y
ECP0458
7
10/63/2019
11/03/2o19
GEN'LAGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 2,000,000
POLICY JECT LOC
PRODUCTS -COMP/OPAGG
$ 2,000,000
-
$
..OTHER. -.
_
_
_
_ _ - _
.- - - .
-
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT -
Ea atdM t
$ -1 ,000,000
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AllTUS
Y
Y
EBA 045
47
10/03/2019
11/03/2019
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE,
Per acd
$
Medical Payments
s 5,000
_
UMBRELLA LNB
OCCUR
EACH OCCURRENCE
$-
AGGREGATE
$
EXCESS UAB
CLAIMS -MADE
I
DED I RETENTION.$
$
B
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY YIN
ANY PROPRIETORlPARTNERIE%ECt/TNE
0FFICERIMEMBEREXCI-UDE07 �
(Mandatory In NH)
NIA
Y
I
WC2097624212
03/15,2019
03/15,2020
SPTA ERm
El EACH ACCIDENT
'._
$ 1,000,000
E.L. DISEASE -EA EMPLOYEE
_
$. 1,000,000
Ifyemdescribe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$ 1,000,000_.
C
Professional Liability
B0621PD
E000118
10/05/2018
11/03/2019
Each Claim
Aggregate
$1,000,000
$2,000,000
Retention
-
$10,000
_ -
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addhlonal
Remarks Schedule, may is auched N more epwe le raqutred)
RE Anheuser Bruch Meter Replacements
The City of Fort Collins is Included as Additional Insured as repuired by
written contract but only as respects to liability arising out of work: performed by the
named Insured. Waiver of subrogation applies.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Utilities ACCORDANCE WITH THE POLICY PROVISIONS.
700 Wood Street
AUTHORIZED REPRESENTATIVE
Fort Collins c0 80521 Y34&RAc 7cwr�fibM.
01988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2916103) The ACORD name and logo are registered marks of ACORD