HomeMy WebLinkAbout109420 HYDRO - PURCHASE ORDER - 2200820Dates 01/31/02
Cityof Fort Collins PURCHASE ORDER NUMBER: 2200820
Page Number: 4 of 1
Delivery Date: 06/01/02 Buyer: DtCK,OPAL
Purchase Order number must appear on invoices, packing lists, labels, bills of lading and all cotresnondonca
1 1LOT
` NMy ROed "ReIW Sewer Phase I
W.O. #H=WRF-2002.3
City of F C pins Director of Purchasing and Risk Management
This order IwInot valid over $2000 unless signed by James B. O'Neill 11, CPPO
City of Fort Collins Purchasing, PO Box 580, Fort Collins, CO 80522.0580
Phone: 970-221-6775 Fax: 970-221.6707 Email: info@ci:fon-coNins.co.us
253,000.00
Total: 253,000,00
Mail Invoices in duplicate to:
City of Fon Coigas
Accounting. Department
PO Box s8o
Fort Co6ins, CO 8OS22.0680
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TTv
ACAORM CERTIFICATE OF LIABILITY INSURANCE
DATE
I 09/ ( 24/0MMIDWYY)1
PRODUCER
......
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc.
ONLY AND 'CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 17th Street, Suite 600
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80202
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
..2-.03 534 -4567
INSURERS AFFORDING COVERAGE
- — - -------- - - - --------------------------- --------- --- - --
RED
Hydro Construction Co., Inc.
- - ------ ---------------- --- - ------- — - -- --- - -- - ----- -- -------------- -
wsuRrRA American CaS of Reading, PA (CNA)
------------ - Co_ - --------- ------- ---- - -- -
----- ____ - _ati
383 West Drake Road, Suite 201
o__
Transportation (_
INSURERS: Transporta ion Insurance Co. CNA)
---------(iNA)
Fort Collins, CO 80526
iNsunEnc-Valley Forge InsuranceCo.--
- --- - --- ----- -
—Assuu-ra- ---
INSU_A_E_R_0_: Plinnacol n c e-
---
I
INSURER — ----- --- ---------- -
THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIM INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI- THE TERMS, EXCLUSION$ AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
----------
INSFI
LTR
TYPE OF INSURANCE
POLICY NUMBER
PUTS =MMNYVY)
nD E�MXF;Wf"OtObF ]I�
— ------- - --------- — ------ -
LIMITS
A
GENERAL LIABILITY
IC1098498800
09/30/01
09/30/02
EACH OCCURRENCE_7$1,
_000, 000
:x COMMEFICALGENEFIALLIADILITY
CLAIMS MADE JX OCCUR
MED EXP (Any ana Person)
w) ---
PEASONAL&ADVNJURY
---- 110-0100
$ �000
S1 , 000 , 000
-
-------
GENERAL AGGREGATE
G
R�EAT�E
[Qi000' 000
QEN'L AGGREGATE LIM IT APPUES PER
— ----------
PRODUCTS -commp Aw
0��
----
11;2 , 0 0 0 , 0 0 0
POLICY LX_l PRO, x -OC
JECr
---- — - - ------
LITY
ANY AUTO
�C1098497775
09/30/01
09/30/02
CC)
COMBINED SINGLE LIMIT
(a weldeffl)
I$i, 000, 000
ISCHEDULEDAUTOS
ALL OWNED AUTOS
BODILY INJURY
$
HIRED AUTOS
------------ -
NON -OWNED AUTOS
(Paaccident)BODILY INJURY
—
PROPERTY DAMAGE
DAMAGE
)AMAGE
%'dlyn
$
(Per a I
GARAGE UASIUTY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER, THAN EA ACC
$
AUTO ONLY: AGG
$
C
BluTYL
CUP1098498828
09/30/01
09/30/02
EACH OCCURRENCE
0-0-0-' 00__0__
�cEss
OCCUR CLAIMS MADE
AGGREGATE___-000
_'_0_QM -
DEDUCTIBLE
— - — - ---------
$
RETENTION $1 0000 ;
-------------- ------- - --
$
D
wommRs. camprnArAM AND
2091550
�04/01/01
04/101/02
X ITwc STAI�
C�T
EMPLOYERS' LIABILITY
T
_ DQ_�MISj_ _J. . . . ...............
E.LEACH ACCIDENT
KIMSEASE-EAEMPLOYEE _$l _00_0 _0_00_
E-L DISEASE -POUCY LIMIT $1,000,000
1
OTHER
DESCRIPTION OF0PMTWM&9.wAmN&vefflCL2MCt.I)$$0N6 ADDED BY rNOORSeMENTISPeCUR. PRMMRM
Re: Work Order Number H-WRF-2002-2, MWRF UV System Improvements, Phase I
�City of Fort Collins
0. Box 580
3 West LaPorte Ave
Fort Collins, Co 80522
SHOULDANYOPTHEABOVr DESCRt"DPOLICIESBECMCOLLEPREFORIE YNE 17
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL 3-0-- =WaMr,
NOTICETOTHE CERTIFICATE HOLDERKAMBOTOTHELEFT, SUTFAILURe TODOSOSHALL
IMPOSE NOOSUGATION ORLUMILRYOFANY RIND UPON THE INSURERITS AGENTS OR
ACOR02"(7/97)1 of 2 #M110384
IGM 0
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 fisted thereon.
AcoRo25-S(7/97)2 of 2 414110384