HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (86)CORM CERTIFICATE OF LIABILITY INSURANCE 3/29/0D°^"'
03129/06
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
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
l.0 V CKA"r*
INSURER A: American Guarantee 8: Lla
INSURER B: National Union Fire Ins Co
INSURER C: 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
POLICY EFFECTIVE
DATE (MMIDDrYY1
POLICY EXPIRATION
DATE fMMIfYY1LIMITS
A
GENERAL LIABILITY
CP0343758101
09/30/05
09/30/06
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx] OCCUR
FIRE DAMAGE (Any one fire)
$300,000
MED EXP (Anyone person)
$10 000
X PD Ded:5,000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 QQQ 0-00
GEN'L AGGREGATE LIM RAPPLIES PER:
PRODUCTS-COMPIOPAGG
s2,000,000
POLICY X PRO-JECT X LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
CP0343758101
09/30/05
09/30/06
COMBINED SINGLE LIMIT
(Ea accident)
1,000
$,000
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NONAWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
S
AUTO ONLY: AGG
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 $10 000
$
C
WORKERS COMPENSATION AND
2091550
DW01/06
04/01/07
X WC STATU- OTH-
'TOR LIMITS rR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: FCWTF Misc. Improvements Project
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
700 Wood St.
Fort Collins, CO 80522
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL&I DAYSWRRTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURERJTS AGENTS OR
�'w J"W' 11 OT L 81111129U806 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 #M290806