HomeMy WebLinkAbout188139 DOHN CONSTRUCTION INC - INSURANCE CERTIFICATE (12)0
DOHNCON-01
CERTIFICATE OF LIABILITY INSURANCE DATE(MAS(DDIYYYY)
6/8/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERSNO 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 N,OT 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 anal conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rigFits to the ceit�cate holder in lieu of such
pendorsements .
PRODUCER NAMME CT -
INSURED
Group
n Parkway Suite 200
)80534
Dohn Construction, Inc. DCI Residential, LLC
2642 Midpoint Drive
Fort Collins, CO 80526
-.wll�l��w�e /�CI9TIr1/�a TG.\Il laan�b. ftMneI^LI all laaOCO.
635-9401
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH,RES_PECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
JJILA
TYPE OF INSURANCE
ADDh
SUER
POUCY NUMBER
POLICY EFF
POLICY EXP
OMITS
X
COMMERCIALGENERALLIABIUTY
CLAIMS -MADE OCCUR
1R57265
10/1/2019
10/1/2020
EACH OCCURRENCE
$ 1,000,000
DAMAGE TOREcNTED
PREMISES (EaMED
$ 5p0,000
EXP (Any oneperson)
$ 10,000
PERSONAL B ADV INJURY
$ 11000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY �X jpcQr LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
..PRODUCTS-COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE LIABILITY
ANY AUTO
SCHEDULED
AURTEOS ONLY AUUpTNNOSYY��..��EEpp
AUTOS ONLY X AUTO�ONLV
1ZS7265
10/1/2019
10/1/2020
COMaBIINED SINGLE LIMB
(EaIx
$ 1,000,000
BODILY INJURY Per erson
$OWNED
BOOpDILY INJURY Per. accident
$
PROa¢iden DAMAGE
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
1P57256
10. 1/2019
10/1/2Q20
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
DIED X RETENTION$ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
N
ANY PROPRIETOR/PARTNER/EXECUTIVE
WFICERIMEM@FAR EXCLUDED?
V^anmy In ^^)
K )res, describe under
DESCRIPTION OF OPERATIONS below
N/A
3055407
7/1/2020
7/1/2021
X PER I OTH-
STATUTE ER
-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
1,000,000
$
E.L. DISEASE - POLICY LIMIT
11000,000
A
Installation Fitr
1057255
10/1/2019-
10/1/2020
Limit
100,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional
RE: Obstrucetion Permit: If required by -written contract, the Certificate
Liability.
Remarks Schedule, may tie attached U mare apace Is required)
Holder Is -Included -as Additional Insured for ongoing operations under General
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins Parkin Services THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
tY g . ACCORDANCE WITH THE POLICY PROVISIONS.
215 North Mason Street lst Floor South Wing
P.O: Box 560
Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03) 619884015 ACORD CORPORATION. All rights reserved.
The ACORD naIl a and logo are registered marks of ACORD