HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATEACORD.M CERTIFICATE OF LIABILITY INSURANCE DATE(MMmDIYY)
09128►06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
VVvc"UrA
INSURER A: American Guarantee & Lia
INSURERB: National Union Fire Ins Co
INSURER C: Plnnacol Assurance
INSURER D:
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TypE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE NY
POLICY EXPIRATION
DATE IMWDDNYILIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
X PD Ded:5,000
CP0343758102
09/30106
09/30►07
EACH OCCURRENCE
$1 DDO 00D
FIRE DAMAGE (Any onefre)
$300000
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2000,000
GENT AGGREGATE LIMITAPPLIES PER:
POLICY X PROJECT X LOC
PRODUCTS - COMPIOP AGG
s2000000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
NOCIUMID)
C
-
TY 01" FOR
2006
COLLINS
COMBINED SINGLE LIMIT
Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMSMADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 0OO 0OO
a
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATI% OTH-
E.L. EACH ACCIDENT
$500DD0
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONSILGCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Work Order #H-WRF. 2004-1 Daft Odor Control.
City of Fort Collins
Attn: P.O. Box 580
300 West LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL gO_ DAYSINRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVE
r\V V . .v t"u, I I OT L 911111314366 AMP1 0 ACORD CORPORATION 1988
ACORD„ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDONY)
09/28/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
VVvcIW CJ
INSURER A: American Guarantee & Lia
INSURER B. National Union Fire Ins Co
INSURER C: Pinnacol Assurance
INSURER D:
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TTB
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
WD
POLICY EXPIRATION
DATE
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx—] OCCUR
X PDDed:5,000
CP0343758102
09/30/06
09/30/07
EACH OCCURRENCE
$1 OOO OOO
FIRE DAMAGE (Anyone fire)
_
$300000
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
$1000000
GENERAL AGGREGATE
$2 OOOw, OOO
GEN'L AGGREGATE LIMITAPPLIES PER:
POLICY X PRO X LOC
PRODUCTS-COMP/OPAGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
��'S1 ,-Y�cv
`L,Nfl�M'-
Mac
CITY
09/30/06
r
,'� .-, ^006
L
-
09/30/07
��.���••��///
�
COMBINED SINGLE LIMIT
(Ea accident)
$1,000 ,OOO
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident))
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
RISK M
N�G�/�L'N
V GI Y
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30106
09/30/07
EACH OCCURRENCE
$1 000,000
AGGREGATE
$1 000 000
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC ST MIT OTH-
S EEL
E.L. EACH ACCIDENT
$SOO,000
E.L. DISEASE -EA EMPLOYEE
s500,000
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Work Order #H-WRF-2006-5, Replacement Program 2006.
City of Fort Collins is included as Additional Insured on the General Liability Policy as required by written contract or
agreement and with respect to work performed by Insured.
City of Fort Collins
300 West LaPorte Avenue
Fort Collins, CO 80522
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYSWRITFEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURERJTS AGENTS OR
�..w %"., II or z FMJ14300 AMP1 0 ACORD CORPORATION 1988
ACD . CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYY)
09/28/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
INSURER A: American Guarantee &
INSURERS: National Union Fire Ins
INSURERC: Pinnacol Assurance
INSURER D:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE DNY)
POLICY EXPIRATION
DATE (MMIDDIYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09/30/07
EACH OCCURRENCE
$1000000
FIRE DAMAGE (Any oi,e fire)
$300000
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIM ITAPPLIES PER:
PRO X LOC
POLICY X]JECT
PRODUCTS-COMP/OPAGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
-
CITY
RISKMANAGEMENT
I I 200
OF FOR"/ COLLINS
ID
COMBINED SINGLE LIMIT
(Ea accident)
$1 ,000 ,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLEX RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATEROYEE$500,000
00
C
WORKERS COMPENSATION AND
2091550
04/01/06
04/01/07
X WC STATU-EMPLOYERS'LIABILMY
E.L. EACH ACCIDE0E.L.
DISEASE -EA
E.L. DISEASE -PO0
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECULL PROVISIONS
RE: Work Order Number: H-WRF-2004-3, Work Order Title: DWRF Digester Gas Piping.
City of Fort Collins is included as Additional Insured on the General Liability Policy as required by written contract or
agreement and with respect to work performed by Insured.
City of Fort Collins
300 W. LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An DAYSWRTrrEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
^��^� �w I".,)I OT z iFIM3T4366 AMP1 0 ACORD CORPORATION 1988
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYY)
09/28/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
GUVCKAUtb
INSURER A: American Guarantee & Lla
INSURER B: National Union Fire Ins Co
INSURER : Pinnacol Assurance
INSURER D:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE
POLICY EXPIRATION
DATE
LIMITS
A
GENERAL LIABILITY
X COMMERC!AL GENERAL LIABILITY
CLAIMS MADE FxJ OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09/30/07
EACH OCCURRENCE
$1 00D 000
I FIRE DAMAGE (Any one fire)
$30D,000
MED EXP (Any one person)
$10 000
PERSONAL&ADV INJURY
$1000000
GENERAL AGGREGATE
$2 DDD 000
GE N'L AGGREGATE L IM ITAPPL IES PER:
POLICY X PRO X LOC
PRODUCTS -COMP/OPAGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
..
09/30/06
i'I IL xf
ryf I�
D9/30/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
Per arson
X
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LABILITY
ANY AUTO
_
CITY
RISK
�, LCOL,����S
AN AGENIF
T
AUTO ONLY - EA ACCIDENT
$
AUTO ONL EA ACC
AUTO ONLY: qGG
$
§
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09130/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 00D 000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LUIBILITY
2091550
04/01/06
04/01/07
X WC DRYSTATIU LIM jS I OTH-
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Backwash Pumpstation.
City of Fort Collins
300 W. LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYSWRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
.. wmu coo v1>rl1 of Y ifM314366 AMP1 0 ACORD CORPORATION 1988
cl:n..Hf• �uG��
YY)
A CERTIFICATE OF LIABILITY INSURANCE
oDATE s/26/9/28/M/DD
eiM. os
PRODUCER
IMA of Colorado, Inc.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600
Denver, CO 80202
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567
INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 60524
INSURER A: American Guarantee & Llab(Zurich)
INSURER B: National Union Fire Ins Co PA(AIG)
NsuRERc: Pinnacol Assurance
INSURER D:
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTRDATE
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
M D
POLICY EXPIRATION
ATE (MMMDIYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx-1 OCCUR
X PD Ded:5,000
CP0343758102
I
09/30/06
a
09/30/07
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Any onefire)
$300000
MED EXP (Any one person)
$10 000
PERSONAL B ADV INJURY
$1000000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
POLICY X PROjECT X LOC
PRODUCTS-COMPIOPAGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALLOWNEDAUTOS
SCHEDULEDAUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
(`
12!)l)[1
,
u}' )'U
RISK MANA
09 30/07
n c
T�i
COLLINS
EMENT
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
(Perr accideODILY nt)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
TH-
X WC STATU- OPR
E.L. EACH ACCIDENT
s500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: General System Improvements.
City of Fort Collins
300 W. LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYSWRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANYKIND UPON THE INSURERJTS AGENTS OR
I9VVRY cov V ���I1 OT z VM314366 AMP7 0 ACORD CORPORATION 1988
ACORDw CERTIFICATE OF LIABILITY INSURANCE DATE(M Dm)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
l wvcR "Co
INSURER A: American Guarantee & Lia
INSURER B: National Union Fire Ins Co
INSURERC: Pinnacol Assurance
INSURER D:
E.
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE I MfDDfYY1
POLICY EXPIRATION
DATE (MMIDDfYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx_] OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09130/07
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Any one fire)
$300000
MED EXP (Any one Person)
$10 000
PERSONAL & ADV INJURY
$1 000 OQO
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIM ITAPPLIES PER:
17 POLICY X PRO X LOC
PRODUCTS -COMP/OP AGG
s2,000,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS'
Drive Other Car
CP0343758102
CITY OF
09/30/06
�d q QQ
C `� =' 2OOp
j'0il'1" COL
09/30/07
NS
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
a
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATU- OTH-
E.L. EACH ACCIDENT
$500 000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500 000
OTHER
DESCRIPTION OF OPERATIONSILOCATONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECUIL PROVISIONS
Re: Pollution Control Lab Remodel.
City of Fort Collins
300 W. LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IM POSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURERJTS AGENTS OR
OT z IFM314355 AMP1 o ACORD CORPORATION 1988
ACORD.M CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYY)
09/28/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
4, V V CKA"=
INSURER A: American Guarantee & Lia
INSURER B: National Union Fire Ins Co
INSURER C: Pinnacol Assurance
INSURER D:
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE
POLICY EXPIRATION
DATE IYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09130/07
EACH OCCURRENCE
$1 00Q 000
FIRE DAMAGE (Anyone fire)
$3000QQ
MED EXP (Anyone person)
$10 000
PERSONAL&ADV INJURY
$1 00Q 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIM ITAPPLIES PER:
POLICY X PRO- X LOC
JECT
PRODUCTS-COMPIOPAGG
$2 0QQ 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
Drive Other Car
CP0343758102
CITY
RISK
�) 1.�
OF FORT
MANAGEMENT
cc
000
COLLINS
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
E1 0Q0 00Q
S
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATU- OTH-
ty
E.L. EACH ACCIDENT
$500 000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
050111111100
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: Poudre 24" Concrete Pipeline Air Vac R.
City of Fort Collins is included as Additional Insured on the General Liability Policy as required by written contract or
agreement and with respect to work performed by Insured.
City of Fort Collins
300 W. LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NOOSLIGATION OR LIABILITYOF ANY KIND UPON THE INSURER,ITS AGENTS OR
M+ Wm" zuu tr»r)1 OT 2 OM314365 AMP1 0 ACORD CORPORATION 1988
ACDM,. CERTIFICATE OF LIABILITY INSURANCE 0928/06D"")
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
I,UV CKAU1zb
INSURER A: American Guarantee & Lia
INSURER B: National Union Fire Ins Co
INSURER C: Pinnacol Assurance
INSURER D:
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSSR
LTRDATE
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
DATE M
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERALLIABILITY
CLAIMS MADE � OCCUR
X PD Ded:5,000
CP0343758102
09130/06
09/30/07
EACH OCCURRENCE
$1 00Q 000
FIRE DAMAGE (Any one fire)
$3000OQ
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
$1 00Q 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
POLICY X PRO- X LOC
PRODUCTS -COMP/OPAGG
$2 000 00-0
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
/ (
CITY OF
RISK M
6
` \ 200(�
V
ORT COLLI
09/30/07
S
COMBINED SINGLE LIMIT
(Ea accident)
$, ,000
1 00Q
X
BODILY INJURY
(Per person)
$
X
BODILYINJUaccident)RY
E
X
X
PROPERTY DAMAGE
PROP cid Y
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X1 OCCUR CLAIMSMADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 00Q 000
AGGREGATE
$1 000 000
a
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATJUCRY LIM 77S I OTH-
FR
E.L. EACH ACCIDENT
E500,000
E.L. DISEASE -EA EMPLOYEE
E500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERAnONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Poudre Pipeline Blackstock Valve Replacement.
City of Fort Collins is included as Additional Insured on the General Liability Policy as required by written contract or
agreement and with respect to work performed by Insured.
City of Fort Collins
300 W. LaPorte Ave.
Fort Collins, CO 80522
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30—DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
REPRESENTATIVE
h�Wmw cav (Irof11 Of 2 OM314366 AMP1 0 ACORD CORPORATION 1988
ACO . CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY)
09/28/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
%1 V V rrcvwueo
INSURER A: American Guarantee & Lie
INSURERS: National Union Fire Ins Co
INSURER Pinnacol Assurance
INSURER E:
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY MM ECTIVE
POLITY EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMM ERCLALGENERALLIABILITY
CLAIMS MADE FXI OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09/30/07
EACH OCCURRENCE
$1 00Q 000
FIRE DAMAGE(Any one fire)
$300D00
MED EXP (Anyone person)
$1 D 000
PERSONAL & ADV INJURY
$1 00D 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIM ITAPPLIES PER:
POLICY FX7 PRO X LOC
JECT
PRODUCTS-COMP/OPAGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
���ryl(\/�
,15�.],LS� \Y
L5
09/30/06
�� ��\\t\]/�{I,��
yy V +-�+
2006
09/30/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILYINJURY
r
ICson
$
X
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
CITY OF FORT
RISK MANAGEMENT
COLLIN
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATII- OTH-
FIR
E.L. EACH ACCIDENT
$500 000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Work Order Number: H-WRF-2005-1, Work Order Title: DWRF Storage Building.
City of Fort Collins Is Included as Additional Insured on the General Liability Policy as required by written contract or
agreement and with respect to work performed by Insured.
City of Fort Collins
300 W. LaPorte Avenue
Fort Collins, CO 80522
SH OULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 30DAYSWRrITEN
NOTICE TOTHE CERTIFICATE HOLDER NAM ED TOTHE LEFT, BUTFAILURE TODD SOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR
REPRESENTATIVE
w�.vlcv cD.� �t/a/17 of 2 #M314366 AMP1 0 ACORD CORPORATION 1988