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Home My WebLink About109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (101)ACORD.M CERTIFICATE OF LIABILITY INSURANCE 06/15104°"Y' 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80202 303 534-4567 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. 301 East Lincoln Avenue Fort Collins, CO 80524 COVERAGES INSURER A: American Cas Co Reading, PA INSURERS: Transportation Insurance 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. IN RI LTR rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE M D LIMITS A GENERAL LIABILITY C1098498800 09/30/03 09/30/04 EACH OCCURRENCE s1 000 000 FIRE DAMAGE (Any one rim) $100000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1XI OCCUR MED EXP (Any one person) _ $5 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIM ITAPPLIES PER: PRODUCTS-COMP/OPAGG $2000000 POLICY X PRO- ECT X LOC A AUTOMOBILE X LIABILITY ANY AUTO C1098497775 09/30/03 09/30/04 COMBINED SINGLE LIMIT (Ea accident) $1r000r000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X X HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO B EXCESS LIABILITY C1098498828 09/30/03 09/30/04 EACH OCCURRENCE $1 000 000 X OCCUR CLAIMS MADE AGGREGATE $1 000 000 a $ DEDUCTIBLE $ X RETENTION $10000 C WORKERS COMPENSATION AND 2091550 04/01/04 04/01/05 X WC STATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EJA EMPL OYEE $100,000 E.L. DISEASE -POLICY LIMIT 1 $500 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL 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 ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30_ DAYSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAM ED TOTHE LEFT, BUTFAILURE TO DOSOSHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR AI,URU L,-O (IrJI)1 Of 2 #M209934 TAR1 Q 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. Acurcuz0-s(ns1)2 or 2 #M209934 ILIA Colorado Page: 002-003 Date: 6/15/2004 Time: 9:48 AM TO: Q 9,19702216619...... 16 Client*-, 19972 CERTIFICATE OF LIABILITY INSURANCE DATE(M0MID ,Are_QMTM 4� PRODUCER IMA of Colorado, Inc. 155017th Street, Suite 600 Denver, CO 80202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 303 634-4567 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. 301 East Lincoln Avenue Fort Collins, CO 80524 INSURER A: American Cas Co Reading, PA (CNA) INSURER B: Transportation Insurance Co (CNA) INSURER C; Pinnacol Assurance NSURERD' 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. LTR N TYPE OFINSURANCC POLICY NUMBER POLICY CTIVE DATE MIDDIVY POLICY RATION ATE IMMODAM LIMITS A GENERAL LIABILITY C1098498800 09/30103 09130/04 EACH OCCURRENCE S1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR FIREDAMAGE(Anymefire) S100000 RED EXP(Any EDP pa ) $5 000 PERSONAL A ADV INJURY 11 000 GENERAL AGGREGATE i2 OOO DOD GENL AGGREGATE LMITAPPLES PER: PRODUCTS -COMPIOPAGG 62000000 X I PRo- Fx-1 LGc POLICY FJECT A AUTOMOBILE X LIABILITY ANY AUTO C1098497775 09/30/03 09/30/04 COMBINED SINGLE LIMIT (EaacadeM) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Pn Pie) $ X X HIREDAUTOS NON-CWNED AUTOS BODILYIWURY (Par acddnd) s PROPERTY DAMAGE (P, Awdad) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT t OTHER THAN EA ACC t ANY AUTO $ AUTO ONLY: AGG B EXCESS uABILITY X OCCUR CLAIMS MADE C1098498828 09/30/03 09/30/04 EACH OCCURRENCE t1 000 000 AGGREGATE t1 00O 000 S $ DEDUCTIBLE X RETENTION S10000 $ C WORKERS COMPENSATION AND 2091550 04101104 04101106 X we STAnN• OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $100,000 El. DISEASE -EA EMPL OYES $100000 E.L. DISEASE - POLICYLMIT 1 $500,000 OTHER DESCRIPTION OF OPERATIONSLOCATIONBIVEHICLESNEXCLUSIONS ADDED BY ENDORSEMENTJSPECIAL 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 S80 Fort Collins, CO 80522 ACORD 25-S (719711 of 9 A M�nDG'ae SHOULD /NYOFTH E MOVE DESCRMED POLICIESBE CANCELLED BEFORE THE EMRATIC14 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TONAIL 30—DAYSWRITTEN NOTICE TOTHE CERTPICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSO SHALL IN POSE NO OBLIGATION OR LIABILITYOF ANYIDND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE �we�. � ernon rnoonowranu •eee Date: 6/15/2004 Times 9:48 AN To: B 9.19702216619...... 16 IKA Colorado Page: 003.003 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. ^uwKwAa trrorl2 Or 2 4M2U9934