HomeMy WebLinkAboutHYDRO - INSURANCE CERTIFICATE (13)Ciinnlli- 10079
MR& CERTIFICATE OF LIABILITY INSURANCE
J
03 9105
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
Denver, CO 60202
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 534-4567
INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
Fort East Lincoln Avenue
Collins, CO 60524
INSURERA: Zurich American Insurance Company
INSURERS: National Union Fire Ins. Co. (AIG)
INSURERC: Pinnacol Assurance
INSURER D:
INSURER E:
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.
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIM
POLICY EXPIRATIONIm
DATE fMMfDDffY)
LIMITS
A
GENERAL LIABILITY
X COMM ERCIALGENERAL LIABILITY
CLAIMS MADE [A] OCCUR
X PD Ded:5,000
CP0343758100
09/30/04
09/30/05
EACH OCCURRENCE
$1 000,000
FIRE DAMAGE (Any one fire)
$309000
MED EXP (Any one Person)
$10000
PERSONAL S ADV INJURY
$1 000 000
GENERAL AGGREGATE
S2 000 000
GEN'L AGGREGATE LIMRAPPLIES PER:
X PRO- X LOC
POLICYJ CT
PRODUCTS -COMPIOPAGG
s2000000
A
AUTOMOBILE
UABILrrY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758100
09/30/04
09/30/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY accident)
(Par accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGO
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE2911514
1
09/30/04
09/30/05
EACH OCCURRENCE
$1 00D 000
AGGREGATE
$1 000 000
S
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/05
04/01/06
X WC STATU- OTH-
-
E.L.EACHACCIDENT
--
5190,060
E.L. DISEASE -EA EMPLOYEE
51D0 060
E.L. DISEASE -POLICY LIMIT
s500 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Work Order Number: H-WRF-2004-3, Work Order Title: DWRF Digester Gas Piping.
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 Ave.
Fort Collins, CO 80522
SHOULD ANYOF THE ABOVE DESCRIBED POLK:IESSE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Rn DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAM ED TOTHE LEFT, BUTFAILURE TO DOSOSHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVE
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