HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (81)ACDRD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDIYY)
03/29106
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
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
INSURER A: American Guarantee &
INSURER B: National Union Fire Ins
INSURER(: 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.
NSR
TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
MNi
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FXI OCCUR
X PD Ded:5,000
CP0343758101
09/30/05
09/30/06
EACH OCCURRENCE_
$1 000 000
FIRE DAMAGC (Any one irce)
$300 000
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
POLICY X PRO- X LOG
PRODUCTS-COMP/OPAGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758101
MUM
09/30/06
COMBINED SINGLE LIMIT
(Ea accident)
$,000
1 000
X
BODILY INJURY
(Per person)
$
X
BODILYINJURY
ident)
(Perraccident)
$
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
09/30/05
09/30/06
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07
X WC STATU- I OTH-
EEL
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: WTF PLC Improvements Program, Improvements to existing plant PLC systems
City of Fort Collins
700 Wood Street
Fort Collins, CO 80521
SHOULD ANYOFTHEABOVE DESCRIBED POLICIESBE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL.In DAYSWRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
REPRESENTATIVE
•`�wmu 40. 1 r1yr1T Or 2 OM290306 - SZM 0 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.
ACORD25s(71e7)2 of 2 #M290806