HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (4)ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DOIYY)
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 & Lie
INSURER B: National Union Fire Ins Co
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.
ILTRNSR
TYPE OF INSURANCE
POLICY NUMBER
POALICY EFFECTIVE
IMMrDDIYY)
OLICY EXPIRATE DATION
POTE
LIMITS
A
GENERAL LIABILITY
X COMM ERCIALGENERAL LIARILITY
CLAIMS MADE 'X, OCCUR
X PD Ded:5,000
CP0343758102
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Any one fire)
s3000OO
MED EXP (Any one person)
$1 O 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2.000.000
7GEN'L AGGREGATE LIMITAPPLIES PER:
POLICY X I 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
09/30/06
09/30/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
1XX
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Par 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
X WC STATU. OTH-
CRY I IMITq PR
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: South West Pump Station:
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 -Utilities
Attn: Opal Dick
P.O. Box 580
Fort Collins, CO 80522
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE TH E 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 TH E INSURERJTS AGENTS OR
^---^•-- �t••�n or rrm4143bb AMP1 0 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(7/87)2 Ot 2 #M3143bb