HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (13)AW-Ra CERTIFICATE OF LIABILITY INSURANCE
DATE (MM DD YV)
03/11/08
PRODUCER 1 303 534 4567
INA of Colorado Inc
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550
Suite 00 600 1Street
Suit
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
Denver CO 80202
INSURED
Hydro Construction Company Inc
INSURERA American Guarantee a List,(Zurich American Ins)
INSURER National Union Fire Ina Cc of PA (AIG)
301 East Lincoln Avenue
INSURER Pinnacol Assurance
INSURER
Fort Collins CO 80524
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
ILTR NSR
TYPE OF INSURANCE
POLICY NUMBER
POUCYEFFECTIVE
IMI
POLICYEXPIRATIONDATE
DATE IM1WDTVVV1
09/30/08
LIMITS
A
GENERAL LIABILITY
CP0343758103
09/30/07
EACH OCCURRENCE
$ 1 000 000
X COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (Any one fire)
$300 000
MED EXP(Any one person)
$10 000
CLAIMS MADE 111 OCCUR
X PD Ded $5 000
PERSONAL S ADV INJURY
$1 000 000
GENERAL AGGREGATE
$ 2 000 000
GEN L AGGREGATE LIMIT APPLIES PER
RO X LOC
17 POLICY X PECT
PRODUCTS COMP/OPAGG
$2 000 000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CP0343758103
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea accident)$
1 000 000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per parson)
$
X
HIRED AUTOS
NON OWNED AUTOS
BODILY INJURY
(Per accitlent)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTOONLY EAACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY AGO
B
EXCESS LIABILITY
X OCCUR El CLAIMS MADE
BES691039
09/30/07
09/30/08
EACH OCCURRENCE
$1 000 000
AGGREGATE
$ 1 000 000
DEDUCTIBLE
X RETENTION $SO 000
$
C
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
2091550
04/01/07
04/01/08
X I WCSTATU OTH
FIR
EL EACH ACCIDENT
$1 000 000
EL DISEASE EA EMPLOYE
$ 1 000 000
EL DISEASE POLICY LIMIT 1
$ 1 000 000
OTHER
E
E
$
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIGNS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract
or agreement and with respect to work performed by Insured subject to the policy terms and conditions
of Fort Collins
Box 580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO $0 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
Fort Collins CO 80522 0000
USA
25-S (7/97) SDZX
S2R92S4
AUTHORMED REPRESENTATIVE
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