HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (17)A R CERTIFICATE OF LIABILITY
INSURANCE
3/21LIIDDY"'
03/21/08
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
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
1550 17th street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Suite 600
Denver CO $0202
INSURERS AFFORDING COVERAGE
INSURED
Hydro Construction Company Inc
INSURER American Guarantee & Liab (Zurich American Ins)
INSURERS National Union Fire Ins Co of PA (AIG)
301 East Lincoln Avenue
INSURER Pinnacol Assurance
INSURER
Fort Collins CO 80524
NSURER E
COVERAGES
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
DAM (IMMITIDMI
POLICY EXPIRATION
DATE iNIM113MY1
LIMITS
A
GENERAL LIABILITY
CP0343758103
09/30/07
09/30/08
EACH OCCURRENCE
$ 1 000 000
FIRE DAMAGE (Anyone fire)
$300 000
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one arson)
$ 10 000
CLAIMS MADE F-XI OCCUR
PERSONAL B ADV INJURY
$1 000 000
X 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
(Ea accident SINGLE LIMIT
$ 1 000 000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIREDAUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTOONLY EAACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
It
AUTO ONLY AGG
B
EXCESS LIABILITY
-XI 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
X WC STATUDRY I OTH
FA
EMPLOYERS LIABILITY
EL EACH ACCIDENT
$ 1 000 000
EL DISEASE EA EMPLOYE
$1 000 000
EL DISEASE POLICY LIMIT
$ 1 000 000
OTHER
E
$
$
DESCRIPTION OF OPERATION&LOCAMONS/VEHICLE&EXCLUSIONS ADDED BY ENDORSEMENTBPECIAL PROVISIONS
RE Work Order #H WTF 2006 6 WTF PLC Improvements 2006 Progress 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
ty of Fort Collins
0 Wood St
rt Collins CO 80521 0000
USA
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
'ORD 25 S (7/97) snzN
iFI:RI
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
(7/971