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Home My WebLink About524939 DOUGLASS COLONY GROUP INC - INSURANCE CERTIFICATE (4)r 0 DATE (MMIDD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 04/24/2017 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 have ADDITIONAL INSURED provisions or 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 TOD aJohnson NAME: y MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 A/C NNo Ext : 800-476-2211 aC No): Birmingham, AL 35202 E-MAIL tohnson me riff.com 9 ennRFSS 1 @ 9 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :American Casualty Co. of Reading, PA INSURED INSURER B :National Fire Insurance Company of Hartford 20478 Douglass Colony Group Inc. 5901 E. 58th Avenue INSURER C : Commerce City, CO 80022 INSURER D INSURER E : rnvCDAccc r`CDTICIrATF NI 111ARFR•7K7RVRIJr, RFVISION NtIMRFR- 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 'ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR I INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 5092131143 05/01/2017 05/01/2018 EACH OCCURRENCE $ 1,000,000 PREMISESEa occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY Fx1 JP LOC $ OTHER: B AUTOMOBILE LIABILITY 5092130851 05/01/2017 05/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NON -OWNED HIRED LX AUTOS ONLY AUTOS ONLY IX BODILY INJURY (Per accident) $ PerOaECentDAMAGE $ A X UMBRELLA LIAR X OCCUR 4018064481 05/01/2017 05/01/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE DED I X I RETENTION $10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROP RI ETOR/PARTNE RJEXEC UTIVE 5092130560 05/01/2017 05/01/2018 X I PER OTH - TA T ER E.L. EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (mandatory in NH) N/A i If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Roof Replacement at Drake Wastewater Treatment Plant, Project Number: 7529 Certificate Holder and any and all parties are Additional Insureds with respects to General Liability and Automobile Liability as required by written contract. General Liability coverage is primary and noncontributory as required by written contract. Policy limits limited to that which are requested in the written contract. Waiver of Subrogation applies when required by written contract. CERTIFICATE HOLDER I ANIa LLAI IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins 215 N. Mason St. 2nd Floor AUTHORIZED REPRESENTATIVE / 1 PO Box 580 Fort Collins, CO 80522 Page 1 of 1 U 1988-ZU15 AGUKU GUKPUKAI IUN. All rlgnts reserve0. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD