HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (46)ACOR M CERTIFICATE OF LIABILITY INSURANCE
2/03 M/DD/YY)
02/03/09
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
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 Ins)
INSURER B: American Guarantee & Liab. (Zurich N. American Ins)
INSURERC:Pinnacol Assurance
301 East Lincoln Avenue
INSURER D:
Fort Collins, CO 80524
INSURER E:
n0VFRAGFR
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
(MM/DD/YYI
POLICDATE
DATEY EXPIRATIONLTR
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
X PD Ded:$5,000
CP0343758104
09/30/08
09/30/09
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any one fire)
S 300, 000
MED EXP (Any one person)
S 10, 000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO X LOC
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
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 000,000
X
BODILY INJURY
(Per person)
S
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 0
AUC593964000
09/30/08
09/30/09
EACH OCCURRENCE
$1,000,000
AGGREGATE
$ 1,000,000
$
i S
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
2091550
04/O1/08
04/O1/09
X N/CSTMOTH-
TORY LIMIT T ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1, 000, 000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
S
S
$
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION
RE: Mercer & Larimer Cty #2 Gate Modifications.
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
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO Box 580
REPRESENTATIVES.
Fort Collins, CO 80522
USA
AUTHORIZED REPRESENTATIVE S
[f
R/IG
ACORD 25-S (7/97) Francine G ACORD CORPORATION 1988
11039920
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 25-S (7/97)