HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (16)A CERTIFICATE OF LIABILITY INSURANCE 03/21/ 8
ORl a D"Y)
PRODUCER 1 303 534 4567 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
INA of Colorado Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
600 HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
Suite 00
Suit 1street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Denver Co 80202 INSURERS AFFORDING COVERAGE
INSURED Hydro Construction Company Inc INSURER American Guarantee & Liab (Zurich American Ina)
INSURERS National Union Fire Ins Cc of PA (AIG)
301 east Lincoln Avenue _,_ _
Fort Collins CO 80524
COVERAGES
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
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
DATE 1110111013MY1
LIMITS
A
GENERAL
LIABILITY
CP0343758103
09/30/07
09/30/08
EACH OCCURRENCE
$ 1 000 000
X
COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (Anyone fire)
$300 000
CLAIMS MADE OCCUR
MED EXP (Any one person)
$10 000
X
PERSONAL B ADV INJURY
$ 1 000 000
PD Ded $5 000
GENERAL AGGREGATE
$ 2 000 000
GEN
L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OPAGG
$2 000 000
POLICY X PRO X LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CP0343758103
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea accident)
$ 1 000 000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILYURY
(Per accident)
$
HIRED AUTOS
NON OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTOONLV EAACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY AGG
B
EXCESS
X
LIABILITY
OCCUR CLAIMS MADE
BES691039
09/30/07
09/30/08
EACH OCCURRENCE
$1 000 000
AGGREGATE
$ 1 000 000
DEDUCTIBLE
X
$
RETENTION $10 000
C
WORKERS COMPENSATION AND
2091550
04/01/08
04/01/09
R WC STATU OTH
EMPLOYERS LIABILITY
EL EACH ACCIDENT
$ 1 000 000
EL DISEASE EA EMPLOYE
$ 1 000 000
EL DISEASE POLICY LIMIT
$ 1 000 000
OTHER
E
E
E
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTMPECIAL PROVISIONS
Re FCNTF Misc Improvements Project 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
-Cm
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
of Fort Collins utilities 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 50 SHALL
Wood St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
Collins CO 80522 0000 1AUTHORIZED
USA
SDZM
iFsr?:1
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