HomeMy WebLinkAboutHYDRO - INSURANCE CERTIFICATE (3)P_IianM!• 10079
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ACOR CERTIFICATE OF LIABILITY
INSURANCE
03127107°m)
PRODUCER
IMA of Colorado, Inc.
1550 17th Street, Suite 600
Denver, CO 80202
303 534-4567
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
INSURER A: American Guarantee & Liatl(Zurich)
INSURER B: National Union Fire Ins Cc PA(AIG)
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.
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD1YY)
POLICY EXPIRATION
DATE (MMIDDNY)
LIMITS
A
GENERAL LIABILITY
X COMM ERCUILGENERAL LIABILITY
CLAIMS MADE OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09/30/07
EACHOCCURRENCE
$1000000
FIRE DAMAGE (Any one fire)
$300000
MED EXP(Any one person)
$10000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2 00D 000
GEN'L AGGREGATE LIMITAPPLIES PER:
JrCT POLICY X PRa X LOD
PRODUCTS-COMP/OP AGG
s2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALLOWNEDAUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758102
09/30/06
09/30/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,ODD,DDD
X
BODILY INJURY
(Par person)
$
X
BODILY INJURY
(Per accident)
$
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
09130/07
EACH OCCURRENCE
$1 00D 000
AGGREGATE
$1 00O 000
s
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/07
04/01108
X WesTATU- OTH-
E.L. EACH ACCIDENT
$1,000 000
E.L. DISEASE -EA EMPLOYEE
$1 000 000
E.L. DISEASE -POLICY LIMIT
1 $1 00D 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: WaterMastewater Treatment and Site Infrastructure Design/Construction Contractor, P1007.
City of Fort Collins
Attn: Mr. James O'Neill II
215 North Mason Street, 2nd
Floor
Fort Collins, CO 80524
SHOULD ANYOFTHE ABOVE DESCRIBED POLICESSE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30DAYS WRITTEN
NOTICE TO TH E CERTIFICATE HOLDER NAM ED TO TH E LEFT, BUT FAILURE TO DO SO SHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
ACORD 25S (719714 of 2 flM33A092
SAM1 0 ACORD CORPORATION 19BE
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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