HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (7)ACOR e CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/D7DYY)
0ATE (M
71
PRODUCER 1-303-534-4567
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1550 17th Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Suite 600
Denver, CO 80202
INSURER'S AFFORDING COVERAGE
INSURED
Hydra Construction Company, Inc.
INSURERA American Guarantee & Lash (Zurich American Ine)
INSURER National Union Fire Ine Co. of PA (AIG)
INSURER Pinnacol Assurance
301 East Lincoln Avenue
INSURER
Fort Collins, CO 80524
INSURER E
rnl¢oanmc
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
INSfl
rypE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATIONDO DATE 11A
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE I X I OCCUR
X PD Ded:$5,000
CP0343758103
09/30/07
09/30/08
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$300, 000
MED EXP(Any one person)
$10,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN L AGGREGATE LIMIT APPLIES PER
POLICY X jECT PRO % LOC
PRODUCTS COMP/OPAGG
$2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758103
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea accident)
$11000,000
%
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per aceiUent)
$
GARAGE LIABILITY
ANY AUTO
AUTOONLY EAACCIDENT
$
OTHERTHAN EAACC
AUTO ONLY AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
% RETENTION $10,000
BE5691039
09/30/07
09/30/08
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/07
04/01/00
WC STATU I OTH-
X I TOBY LIMITS ER
E L EACH ACCIDENT
$ 1,000,000
EL DISEASE - EA EMPLOYEE
$1, 000,000
EL DISEASE -POLICY LIMIT
$1, 000,000
OTHER
E
E
E
DESCRIPTION OF OPERATIONWLOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Cathodic Protection Improvements, Fort Collins, CO. City of Fort Collins is included as Additional Insured on the
General Liability Policy if required by written contract or agreement and with respect to work performed by Insured
subject to the policy terms and conditions
(.CFI I IFIGA I It 11ULULN I I ADDITIONAL INSURED, INSURER LETTER L,AINL,CLLAI HUM
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
700 Wood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES
Fort Collins, CO 80521-0000 AUTHORIZED REPRESENTATIVE
USA
ACORD 25-S (7/97) SDZM O ACORD CORPORATION 1988
7197831
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