HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (97)AC_ RD. CERTIFICATE 4F LIABILITY INSURANCE 09/26/05""
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
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
rnVFRAAFR
INSURERS: National Union Fire Ins Co
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE (NIMIDDIM
POLICY EXPIRATIONIm
DATE iMMMOPM
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [i] OCCUR
X PDDed:5,000
CP0343758101
09/30/05
09/30/06
EACH OCCURRENCE
$1 00D 000
FIRE DAMAGE (Any one fire)
$300000
MED EXP (Any one person)
$1 D 000
PERSONAL & ADV INJURY
$1000000
GENERAL AGGREGATE
$2 000 000
GEML AGGREGATE LIM ITAPPLIES PER:
JECT POLICY X PRO-X LOC
PRODUCTS -COMP/OP AGG
$2 000 000
A
AuroMostLE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758101
09/30105
09/30/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,DD0
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10 000
BE9033798
09130/05
09/30/06
EACH OCCURRENCE
$1 00D 00D
AGGREGATE
$1 00D 000
S
$
$
C
woRKERs coMPENsATION AND
EMPLOYERS' LIABILITY
2091550
04101/05
04/01/06
-
X WC STATUDRY LIM - I JOTHER
E.L. EACH ACCIDENT
$1,000 D0D
E.L. DISEASE - FA EMPLOYEE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSXNIS ADDED BY ENDORSEMENTISPECIAL 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 TH E ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL 30 DAYSWRnTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSH/LLL
IM POSE NO OBLIGATION OR LIABILITY OF ANYIOND UPON TH E INSURER,ITS AGENTS OR
AL,UnU cD.S Irreill of 2 #M270427 SZM O AGORD CURPURATION 1933
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AMR& CERTIFICATE OF LIABILITY
INSURANCE °`�"'
09/22610
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 5344567
INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
INSURER A: Zurich American Insurance Company
INSURER B: National Union Fire Ins Co PA(AIG)
INSURER a. Pinnacol Assurance
Fort Collins, CO 80524
INSURER D:
INSURER E:
COVERAGES
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 (MMIDDJYYI
POLICY EXPIRATION
DATE (MMMDIYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE I X1 OCCUR
X PD Ded:5,000
CP0343758101
09/30/05
09/30/06
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Any one fire)
$300000
MED EXP (Any one Person)
$10 000
PERSONAL 8 ADV INJURY
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM IT APPLIES PER:
POLICY X PROJECT X LOC
PRODUCTS-COMP/OP AGG
"000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758101
09130105
09130/06
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per Person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
CE EXSS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10 000
BE9033798
09/30105
09/30/06
EACH OCCURRENCE
s1 000 000
AGGREGATE
$1 000 000
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/05
04/01/06
X WC STATIT DTH-
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 ENDORSEMENTISPECW. PROVISIONS
RE: Work Order #H-WRF. 2004-1 Daft Odor Control.
City of Fort Collins
Attn: P.O. Box 580
300 West LaPorte Ave.
Fort Collins, CO 80522
ACORD 25S 171971,t —f O 40JIg7nAn7
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDER NAM ED TOTHE LEFT, BUT FAILURE TO DO SOSHALL
IMPOSE NO OB LIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR
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