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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (28)ACORD. CERTIFICATE OF LIABILITY INSURANCE DAT08/08°""' 10/08/OB 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 1550 17th Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 600 Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American ins) INSURER B: American Guarantee & List. (Zurich N. American Ins) 301 East Lincoln Avenue INSURER C:Pinnacol Assurance INSURER D: Fort Collins, CO 80524 INSURER E: COVFRAQFC 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 LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $1,000, 000 FIRE DAMAGE (Any one lire) $300,000 X COMMERCIAL GENERAL LIABILITY MEDEXP(Any oneperson) $10, 000 71 CLAIMS MADE FxIOCCUR PERSONAL &ADV INJURY $ 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $2,000,000 POLICY_X PROX LOC A ALI X OMOBILELIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 LIMIT (Ea accident) $1,000, 000 BODILY INJURY (Per person) $ ALL ALL OWNED AUTOS SCHEDULED AUTOS X BODILY accide t) (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO B EXCESS X 1 LIABILITY OCCUR D CLAIMS MADE AUCS93964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DEDUCTIBLE X $ RETENTION $0 C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09 TWOATUCRY LIM - GTH EMPLOYERS' LIABILITY CCIDENT $ 1, 000, 000 00 7DISEASE -POLICY LIMIT $ 1,000,000 OTHER 5 S S DESCRIPTION OF OPERATIONS/LOCATION$NEHICLES/EXCLUSIONS 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 subject to the policy terms and conditions. Re: rouare e.ipetlne improvements ana Valve Replacement, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Larimer County, CO. City of Fort Collins 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 700 Wood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80521-0000 AUTHORIZED REPRESENTATIVE USA l/ ACORD 25-S (7/97) crunderwood © ACORD CORPORATION 1988 10026874 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. ADMRM CERTIFICATE OF LIABILITY INSURANCE 0/08M(DOrvV) 10/08/OB ,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 1550 17th Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 600 Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ina) INSURER B: American Guarantee & Liab. (Zurich N. American Ins) 301 East Lincoln Avenue INSURER C:PinnaC01 Assurance INSURER D: Fort Collins, CO 80524 INSURER 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 POLICY EXPIRATION fMWDDNYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR X PD Ded:$5,000 CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $300,000 MED EXP (Any one person) $ 10, 000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: _X PRO 51 LOG PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CP0343758104 09/30/08 09/30/09 cnt) SINGLE LIMIT (Ea accident) y1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accitlenl) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO $ $ R EXCESS LIABILITY X OCCUR CLAIMS MADE XIDEDUCTIBLE$ RETENTION $0 AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2091550 04/01/08 04/01/09 % WCSTATU GTH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1, 00 0, 000 E.L. DISEASE -POLICY LIMIT S1,000,000 OTHER s S S DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLE$/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ty of Fort Collins 0 Wood Street 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 rt Collins, CO 80524 USA I CORD 25-S (7/97) crunderwood 10026880 AUTHORIZED REPRESENTATIVE O ACORD CORPORATION 1988 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. A_ CO�a CERTIFICATE OF LIABILITY INSURANCE I 10�0 0Y' PRODUCER 1-303-534-4567 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION (INA of Colorado. Inc. I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1550 17th Street Suite 600 Denver, CO 80202 Hydro Construction Company, Inc. 301 East Lincoln Avenue Collins, CO 80524 COVERAGES INSURERS AFFORDING COVERAGE I INSURER B: American Guarantee & List. (Zurich N. American Ins)I 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 NUMBEfl POLICY EFFECTIVE POLICY EXPIRATIONLTR MMIDDNYI LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $300,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE III OCCUR MED EXP (Any one persond $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO X LOC A AUTOMOBILE LIABILITY ANY AUTO CPO343758104 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 g BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS LIABILITY AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 S $ DEDUCTIBLE $ X RETENTION $0 C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09 X WC STATUS GTH EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 OTHER 5 5 $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins is included as Additional Insureds 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. CERTIFICATE HOLDER I I ADDITIONAL INSURED- INSURER I ETTER- CANCELLATION RE: Poudre River Screen -Equipment Purchase. SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION City of Fort Collins 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 700 Wood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80521-0000 USA AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) crunderwood O ACORD CORPORATION 1988 10026850 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. ABM CERTIFICATE OF LIABILITY INSURANCE M/DD YY) 0/E08 10//08 PRODUCER 1-303-534-4567 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1550 17th Street Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80202 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ina) INSURERS: American Guarantee & List. (Zurich N. American Ins) 301 East Lincoln Avenue INSURER C:Pinnacol Assurance INSURER D: Fort Collins, CO 80524 INSURER E: UUVFHAUFti 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 MMi LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1, 000, 000 FIRE DAMAGE(An one fire) $300,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) S 10, 000 CLAIMS MADE 1XI OCCUR PERSONAL &ADV INJURY _ $ 1,000,000 X PD Ded:$5,000 GENERALAGGREGATE $2, 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000, 000 11 POLICY r X PRO r—xl LOC A AUTOMOBILE X LIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 (a acciden1151NGLE LIMIT $1, 000, 000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY (Per accident) enl) $ HIRED AUTOS NON�O OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: qGG B EXCESS LIABILITY X I OCCUR CLAIMS MADE AUCS93964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ JDEDUCTIBLE $ X RETENTION $ 0 C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09 X WC STATU OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER 5 5 5 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Cathodic Protection Improvements, Fort Collins, CO. 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins 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 700 Wood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80521-0000 AUTHORIZED REPRESENTATIVE A USA [/ ACORD 25-S (7/97) crunderwood O ACORD CORPORATION 19RR Ice, ..0U ITMOT.-TERTH 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. 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. ACORD_M CERTIFICATE OF LIABILITY INSURANCE 1DATEo/o8/08 YY) /as 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 80202 INSURERS AFFORDING COVERAGE O Construction Company, Inc. East Lincoln Avenue Collins, CO 80524 .VVCtSHUMO INSURER B: American Guarantee & Liab. (Zurich N. American Ins)I INSURER C: Pinnacol Assurance I 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 PATF OLICY EXPIRATION LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 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 1XIOCCUR PERSONAL &ADV INJURY $ 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY r X PRO- rX1 LOD A AUTOMOBILE X LIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 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 AUTO ONLY - EA ACCIDENT $ OTHETHAN EA ACC $ ANY AUTO $ AUTOONLY: AUTO OAGO B EXCESS LIABILITY X I OCCUR 1:1CLAIMS MADE AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $1,000,000 AGGREGATE $ 1,000,000 DEDUCTIBLE $ X RETENTION $ 0 C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09 X WC STAT(U7- OTH EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 OTHER s 5 $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: FCWTF 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. City of Fort Collins - Utilities 700 Wood St. Fort Collins, CO 80522-0000 USA ACORD 25-S (7/97) 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 ZED REPRESENTATIVE S C/ O TION 1988 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. A_ CAM CERTIFICATE OF LIABILITY INSURANCE 10/0/08 DATE8/08DfYY) 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 80202 INSURERS AFFORDING COVERAGE INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ina) INSURER B: American Guarantee & List. (Zurich N. American Ina) 301 East Lincoln Avenue INSURER C: Pinnacol Assurance INSURER D: Fort Collins, CO 80524 INSURER 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 POLICY EXPIRATIONAiii- LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000, 000 FIRE DAMAGE(Anyone fire) $300,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADEIT] OCCUR MED EXP(Any one person) $10, 000 PERSONAL &ADV INJURY $ 1, 000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO X LOC A AUTOMOBILE g LIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 nl)SINGLE LIMIT Be accident) $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 AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY: AGG E EXCESS LIABILITY AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 OCCUR 0 CLAIMS MADE X 1 AGGREGATE $ 1, 000, 000 $ DEDUCTIBLE X $ RETENTION $ 0 C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09GTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1, 000, 000 E.L. DISEASE -EA EMPLOYE $1, 000, 000 E.L. DISEASE -POLICY LIMIT $ 1, 000, 000 OTHER 5 S s DESCRIPTION OF OPERATION$/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: WTF Replacement Program 2007 General Systems Imps- Phase II, Fort Collins Water Treatment Facility, 4316 West LaPort Ave, Fort Collins, CO 80521. 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. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins 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 700 Wood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80521-0000 AUTHORIZED REPRESENTATIVE A USA / ACORD 25-S (7197) crunderwood O ACORD CORPORATION 1988 iuuzoeoa 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. AACOR CERTIFICATE OF LIABILITY INSURANCE �008 "Y) n, 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 Suit 1street Suite 00 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Denver, cD 80202 INSURED Hydro Construction Company, Inc. INSURER A: American Guarantee & Liab. (Zurich American Ins) INSURER B: American Guarantee & Liab. (Zurich N. American ins) 301 East Lincoln Avenue INSURERC: Pinnacol Assurance INSURER D: 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 SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. —SR TIN TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE g 1, 000, 000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(An one fire) $300,000 CLAIMS MADE aOCCUR MED EXP(Any one person) $10,000 X PD Ded:$5,000 PERSONAL&ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $ 2,000,000 SENT AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGO $2,000,000 POLICY X PRO' X LOC A AUTOMOBILE LIABILITY CP0343758104 09/30/08 09/30/09 X COMBINEDSINGLELIMIT $1, 000, 000 ANY AUTO (Eaccident) ALL OWNED AUTOS DOINJURY $ SCHEDULED AUTOS (Perr person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC $ $ AUTO ONLY. AUTOO AGG E EXCESS LIABILITY -XI AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 S DEDUCTIBLE X RETENTION $0 $ C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09 X WCSTATU- OTH EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1, 000, 000 E.L.DISEASE-EAEMPLOYE $1,000,000 E.L. DISEASE POLICY LIMIT $ 1,000,000 OTHER 5 s $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Work Order #H-WTF-2006-6, WTF PLC Improvements 2006 Program. 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. City of Fort Collins 700 Wood St. Fort Collins, CO 80521-0000 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 ACORD AUTHORIZED REPRESENTATIVE S� USA L/ O fiU1d1 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. 25-S AB10/M CERTIFICATE OF LIABILITY INSURANCE 0/E08/08D/YY) 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 80202 INSURERS AFFORDING COVERAGE INSURED INSURER A: American Guarantee & Liab. (Zurich American Ina) Hydro Construction Company, Inc. INSURER B: American Guarantee & Liab. (Zurich N. American Ins) 301 East Lincoln Avenue INSURER C: Pinnacol Assurance Collins, CO 80524 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 MMIDONYI LIMITS A GENERAL LIABILITY CP0343758104 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Anyone fire) $300,000 X COMMERCIAL GENERAL LIABILITY VIED EXP Any one person) $10,000 CLAIMS MADE El OCCUR PERSONAL &ADV INJURY $ 1,000,000 X PD Ded:$5,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 17 POLICY F X PRO X LOC A AUTOMOBILE X LIABILITY ANY AUTO CP0343758104 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $11000,000 BODILYIon) (Perrper person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHEEA ACC THAN $ ANY AUTO $ AUTO AUTO ONLY: AGG A EXCESS LIABILITY X OCCUR CLAIMS MADE AUC593964000 09/30/08 09/30/09 EACH OCCURRENCE $1,000,000 AGGREGATE $ 1,000,000 $ DEDUCTIBLE $ X RETENTION $0 C WORKERS COMPENSATION AND 2091550 04/01/08 04/01/09 X WCSTATU- OTH- EMPLOVERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1, 000,000 E.L. DISEASE POLICY LIMIT $ 1, 000,000 OTHER S S S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: DWRF Preliminary & Solids Odor Control, Fort Collins Colorado. City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement subject to the policy terms and conditions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins 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 700 Wood Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE USA ACORD 25-S (71971 crunderwood (B ACORD CORPORATION 1AAA 1UUZbttbl