HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (3)ruanrf• IQQ79
HYDRCON
ACORD.. CERTIFICATE OF LIABILITY
INSURANCE
0928/ 6°"Y'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc.
1550 17th Street, Suite 600
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80202
303 534-4567
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: American Guarantee & Liab(Zurich)
Hydro Construction Company, Inc.
301 East Lincoln Avenue
INSURERS: National Union Fire Ins Co PA(AIG)
INSURER c: PinnacoI Assurance
Fort Collins, CO 80524
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
1MM1DO!YY1
09/30/06
ICY
POLDATE
M PIRATIONLTR
LIMITS
A
GENERAL LIABILITY
X COMMERCIALCENERALLIABILRY
CLAIMS MADE FXI OCCUR
X PD Ded:5,000
CP0343758102
09/30/07
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Any one6ne)
$300000
MED EXP (Anyone person)
$10 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE L IM ITAPPLIES PER:
PROPOLICY x JEC X LOC
PRODUCTS -COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Drive Other Car
CP0343758102
/'�Y1
1 1
��]��,�J�/
{ h,�
09/30/06
" 2006
09/30/07
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
CITY OF FORT
RISK MANAGEMENT
COLLINC
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR 7 CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE0831894
09130/06
09/30/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1000000
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATU- I OTH-
EEL
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: 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
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 NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVE
A+ UKIU zDN (1181)1 of 2 #M314366 AMP1 o ACORD CORPORATION 1988
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.
ACORD25S(7/e7)2 of 2 #M314366