HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (10)w CERTIFICATE OF LIABILITY INSURANCE DATE3/07 YY)
A_ Ca10/0/07
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 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
COVERAGES
INSURER National Union Fire Ina Co. of PA (AIG) I
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
POLICYEXPIRATION
DATE IMMIDDNYI,
LIMITS
A
GENERAL LIABILITY
CP0343758103
09/30/07
09/30/08
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Anyone lire)
$300,000
X COMMERCIAL GENERAL LIABILITY
MED EXF(Any one pemcn)
$10,000
CLAIMS MADE 7 OCCUR
PERSONAL B ADV INJURY
$ 1,000,000
X PD Dad $5,000
GENERAL AGGREGATE
$2,000,000
GEN L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OPAGG
$2,000,000
POLICY X PRO X LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CP0343758103
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea accident)
$11000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GAR AGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
7
$
AUTO ONLY AGG
E
EXCESS LIABILITY
BE5691039
09/30/07
09/30/08
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
X OCCUR CLAIMS MADE
$
DEDUCTIBLE
$
X RETENTION $10,000
C
WORKERS COMPENSATION AND
2091550
04/01/07
04/01/08
X WC STATT- OTH
E L EACH ACCIDENT
$ 1,000,000
EMPLOYERS' LIABILITY
E L DISEASE EA EMPLOYE
$ 1,000,000
E L DISEASE POLICY LIMIT
$ 1,000,000
OTHER
S
s
$
DESCRIPTION OF OPERATIONWLOCATONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE Work Order #H-WTF-2006-6, WTF PLC Improvements 2006 Program. 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 sub3ect to the policy terms and conditions.
ULK I III 1 t HULULK I I ADDITIONAL INSURED INSURER LETTER I:ANt;LLLA I RUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
F700W-od
FortCollins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
StIMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES
llins, CO 80521-0000 AUTHORIZED REPRESENTATIVE Q_r ..AILS
USA
SDZM
G ACORD
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 enclorsement(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