HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (95)m,
ACORD. CERTIFICATE OF LIABILITY INSURANCE 0DATE 9/26/9/261 MIDD YY)
05
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.
303 534-4567 INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
INSURER A: Zurich American Insurance
INSURER B: National Union Fire Ins Co I
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.
LTR NSR
rypE OF INSURANCE
POLICY NUMBER
POLICYEFFECTNE
DATE (MMIDDIYYI
POLICY EXPIRATION
DATE (MMIDD/YY)
LIMBS
A
GENERAL LIABILITY
CP0343758101
09/30/05
09/30/06
EACH OCCURRENCE
$1 QQQ QQQ
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
FIRE DAMAGE (Any one fire)
$300000
MED EXP (Anyone person)
$10000
X PD Ded:5,000
PERSONAL&ADV INJURY
$1 0OQ 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
POLICY X PRO X LOC
PRODUCTS - COMP/OP AGG
$2000000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CP0343758101
09/30/05
09/30/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per Person)
$
HIREDAUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
ANY AUTO
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
BE9033798
09/30/05
09/30/06
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,000
DEDUCTIBLE
X RETENTION $10000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LL4BILITY
2091550
04/01/05
Q4/01/06
X WC STIMIT OTH-
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Work Order Number: H-WRF-2005-1, Work Order Title: DWRF Storage Building.
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.
CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER CANCELLATION
SHOULD ANYOFTH E ABOVE DESCRIBED POLICMS BE CANCELLED BEFORE THE ExFmTON
City of Fort Collins
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL3Q—DAYS WRITTEN
300 W. LaPorte Avenue
NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TO DOSOSH ALL
Fort Collins, CO 80522
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND U PON TH E INSURERLITS AGENTS OR
REPRESENTATIVES.
A THOR2ED REPRESENTATIVE
�wVlvrll oT-1 SM270427 SZM 0 ACORD CORPORATION 1988