HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (83)ACORDTa CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDI Y)
03/29/06
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 INSURER A: American Guarantee & Llah.(Zurich)
Hydro Construction Company, Inc. INSURER B: National Union Fire Ins Co PA(AIG)
301 East Lincoln Avenue INSURERC: Pinnacol Assurance
Fort Collins, CO 80524 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
DATE IMWDDNYi
POLICY EXPIRATION
DATE (wgi
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
X PD Ded:5,000
CP0343758101
09/30/05
09/30/06
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Any me fire)
$3000OO
MED EXP (Any one person)
$10 000
PERSONAL &ADV INJURY
$1000000
GENERAL AGGREGATE
$2 OOOw, 000
GEN'L AGGREGATE LIM ITAPPL IES PER:
POLICY X PROJECTX LOC
PRODUCTS -COMPIOPAGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CP0343758101
09/30/05
09/30/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
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 17 CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
BE9033798
09/30/05
09/30/06
EACH OCCURRENCE
$1 00O 000
AGGREGATE
$1 00O 000
a
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/01/06
04/01/07 1X
WCSTATIU oTH-
E.L. EACH ACCIDENT
$500,000 -
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500 000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECUIL PROVISIONS
Re: WTF PAC Feed System & PLC Modifications, Reconstruction of existing PAC system.
City of Fort Collins
700 Wood Street
Fort Collins, CO 80521
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MML3O_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUT FAILURE TODD SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVE
- -- - "•-• r 1 011 c N•mcaucuo 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(7197)2 Of 2 #M29U8Ub