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HomeMy WebLinkAbout551106 DS CONSTRUCTORS LLC - INSURANCE CERTIFICATE (3)ACORO® CERTIFICATE OF LIABILITY INSURANCE DAT2/18/2017 Y) 12/18/2017 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 AMEND, 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 policy(ies) must be endorsed. If 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 in lieu of such endorsement(s). PRODUCER CONTACT NAME: Olson & Olson Ltd _ _ _ PHONE FAX 5655 S. Yosemite St. #200 A/C No Ext: 303-867-2055 A/C No:303-867-2074 ADDRIESS: o2@olsonandolson.com Greenwood Village CO 80111 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westfield Insurance Company 24112 INSURED DSCON-1 INSURER B : Plnnacol Assurance 41190 DS Constructors, LLC 3780 N. Garfield Ave., Ste 101 INSURER c :Columbia Casualty Co 31127 INSURER D : Loveland CO 80538 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1928011032 REVISION NUMBER: 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY TRA5154002 1/1/2018 1/1/2019 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGEPREMISESS ( RENTED Ea occurrence) _ $ 5D0,000 CLAIMS -MADE OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO- LOC A AUTOMOBILE LIABILITY TRA5154002 1/1/2018 1/1/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS $ A X UMBRELLA LIAB X OCCUR TRA5154002 1/1/2018 1/1/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,DOO,ODD EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 0 $ g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN 4130202 1/1/2018 1/1/2019 X WC STATU- OTH- T RY II ER ANY PRO PRI OFFICER/MEMBER/PART EXCLUDED? ECUTIVE ] N / A E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ I,DOg000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 1,000, 00D C Pollution 2088389111 1/1/2018 1/1/2019 Per Claim 1,000,000 Claims -Made Form Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder and those listed below (if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Non -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. 8531 EPIC Pool Deck Tile Replacement. GLK I IFIGA I L City of Fort Collins Financial Services Purchasing Division PO Box 580 Fort Collins CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD