HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (15)C. CERTIFICATE OF LIABILITY INSURANCE
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03/21/08
PRODUCER 1 303 534 4567
INA of Colorado Inc
1550 17th Street
Suite 600
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
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 & Liab (Zurich American Ins)
INSURER National Union Fire Ina Co of PA (AIG)
301 East Lincoln Avenue
INSURERC Pinnacol Assurance
INSURERD
Fort Collins CO 80524
INSURER E
envwwr_ce
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
ILIA NSR
TYPE OF INSURANCE
POLICY NUMBERDATE
POLICY EFFECTVINEArn�E
09/30/07
POLICY EXPIRATION
09/30/08
LIMITS
AGENEMLLIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx� OCCUR
X PD Ded $5 000
CP0343758103
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Anyone fire)
$300 000
MED EXP(An ono ersan)
$ 10 000
PERSONAL& ADV INJURY
$ 1 000 000
GENERAL AGGREGATE
$ 2 000 000
GEN L AGGREGATE
POLICY
LIMIT APPLIES PER
FX I PRO X LOC
PRODUCTS COMP/OPAGG
$2 000 000
A
AU70MOSILELIABILITY
X
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON OWNED AUTOS
CP0343758103
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea eccidem)
$ 1 000 000
INJURY
(Per person)
$
X
X
BODILY INJURY
(Par accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
ANY AUTO
AUTOONLY EAACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY AGO
$
$
e
EXCESS
X
LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $10 000
885691039
09/30/07
09/30/08
EACH OCCURRENCE
$ 1 000 000
AGGREGATE
$ 1 000 000
$
X
C
WORKERS COMPENSATION AND
EMPLOYERSRS LIABILITY
OTHER
2091550
04/01/08
04/01/09
X WC STATU OTH
EL EACH ACCIDENT
$1 000 000
EL DISEASE EAEMPLOYE
$1 000 000
EL DISEASE POLICY LIMIT $ 1 000 000
E
$
$
DESCRIPTION OF OPERATIONSfLOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE WTF 2008 General System Improvements 7 Phase I 7 work order $ H WTF 2008 2
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
CFRTIFICATr Mnl nco I I
of Fort Collins
Box 580
Fort Collins CO 80522 0000
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 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVE
USA
25 S (7/97) SDZN
A34nwan
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) authonzed 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