HomeMy WebLinkAboutHYDRO - INSURANCE CERTIFICATE (4)ClianHf• 1GG79
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a.9LLilitrrw CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
IMA of Colorado, Inc.
155017th 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 & Llab(Zurich)
INSURER B: National Union Fire Ins Co PA(AIG)
INSURER C: Pinnacol Assurance
INSURER D:
INSURER E:
COVERAGES
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
POLICY EXPIRATION
LIMBS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
X PD Ded•5,000
CP0343758102
09/30/06
09/30/07
EACH OCCURRENCE
$1 00O 000
FIRE DAMAGE (Any one Are)
$300000
MED EXP (Any one person)
$10000
PERSONAL S ADV INJURY
$1 00O 000
GENERAL AGGREGATE
s2,000.000
GEN'L AGGREGATE LIM IT APPLIES PER:
POLICY X PRJFCO- X LOC
PRODUCTS-COMP/OPAGG
S2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIRED AUTOS
NON-OWNEDAUTOS
CP0343758102
09/30/06
09/30/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per Person)
$
X
BODILY INJURY
Per amwent)
$
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 QQO 000
AGGREGATE
$1 00O 000
S
$
$
ti
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
O4/O1/O7
D4/O1/O6
WC TH-
X STATU- OER
E.L. EACH ACCIDENT
51 QOO,OOO
E.L. DISEASE -EA EMPLOYEE
S7 OOO 000
E.L. DISEASE -POLICY LIMIT
1 $1 000 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS 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 ANYOFTHE ABOVE DESCRIBED POLX:ESSE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3Q_ DAYSWRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFNLURE TODOSOSHALL
IM POSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVE
AI URV CDV tl1w 11 or Z 8M334UBZ SAM1 o AGUKU GOKFOKATION 1933
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.
AaoRo2ss(7197)2 of 2 #14334092