HomeMy WebLinkAbout113618 AQUA ENGINEERING - INSURANCE CERTIFICATE (2)Client# 1530
ACORD.n CERTIFICATE
OF LIABILITY
INSURANCE
05/06108°"Y'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp
ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway Suite 1000
Denver CO 80203
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
303 837 8500
INSURERS AFFORDING COVERAGE
INSURED
Aqua Engineering Inc
Fort Innovation Drive
Fort Collins CO 80525
INSURER
St Paul Insurance(Med/A&E)
INSURER B
Hartford Casualty Insurance Cc
INSURER C
Travelers Insurance (Mod/A&E)
INSURER D
Hartford Accident & Indemnity Co
INSURER E
XL Specialty Insurance Company
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
NSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICVEFFECTWE
DATE MM/DD
POLICY EXPIRATION
DATE (MM/DD1YYI
LIMITS
A
GENERAL LIABILITY
680153BLO91TIA07
05/05/08
05/05/09
EACH OCCURRENCE
$1y000.000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [A] OCCUR
FIRE DAMAGE (Any one fire)
_
$1000000
MED EXP (Any one person)
_
$1 O 000
PERSONAL & ADV INJURY
_
$1 00O 000
GENERAL AGGREGATE
_
s2,000,000
GEN L AGGREGATE LIMITAPPL IES PER
PRODUCTS COMP/OPAGG
_
$200000-0
POLICY PERO LOC
_
B
AUTOMOBILE
X
LIABILITY
ANY AUTO
34UECIS1066
05/05/08
05/05/09
COMBINED SINGLE LIMIT
(Ea amident)
$1 000 000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
HIRED AUTOS
NON OWNED AUTOS
BODILY INJURY
(Per ecnatlent)
$
X
PPROPERTY DAMAGE
(Peracadent)
$
GARAGE LIABILITY
AUTOONLY EAACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY AGO
C
EXCESS LIABILITY
X OCCUR CLAIMS MADE
XSFCUP630SY439INDO
05/05/08
05/05/09
EACH OCCURRENCE
s3,000,000
AGGREGATE
s3.000.000
$
DEDUCTIBLE
$
RETENTION $
D
WORKERSCOMPENSATION AND
EMPLOYERS LIABILITY
34WEGKC2904
05/05/08
05/05/09
X WCSTATU OTH
ER
EL EACH ACCIDENT
E1 000000
E L DISEASE EA EMPLOYEE
$1 000 000
EL DISEASE POLICY LIMIT
$1 OOO 000
E I
OTHER Professional
lability
laims Made
DPR9612622
05/05/08
05/05/09
$1 000 000 per claim
$1 000 000 annl aggr
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Ft Collins
Purchasing Division
PO Box 580
Fort Collins CO 80522 0580
SH OULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TOMAIL 3IIL OAYSWRI TEN
NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
IMPOSE NO OB LIGATION OR LIABILITY OF ANY MND UPON THE INSURER ITS AGENTS OR
AUTH_O`RIIZED_REPRE
ACORD 25 S (7/97)1 of 2 UMS31799
rnur n nrnon rnoono nrrnu �000
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(7/97)2 Of 2 4M531799