HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (37)AC � CERTIFICATE ®F LIABILITY INSU NCE
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0/07
10/07/09
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 6 Liab. (Zurich N. American Ins)
301 East Lincoln Avenue
INSURER C:Pinnacol Assurance
INSURERD:
Fort Collins, CO 80524
INSURERE:
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
LIMITS
A
GENERAL LIABILITY
CP0343758105
09/30/09
09/30/10
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Anyone fire)
$ 300, 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a 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- JECT X LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CP0343758105
09/30/09
09/30/10
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
X
X
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY- EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
B
EXCESS LIABILITY
AUC593964001
09/30/09
09/30/10
EACH OCCURRENCE
$ 1,000,000
X1 OCCUR CLAIMS MADE
AGGREGATE
$1,000,000
$
DEDUCTIBLE
$
X RETENTION $ 0
C
WORKERS COMPENSATION AND
2091550
04/01/09
04/01/10
X I WCSTATU- OTH-
TORYLIMITSI ER
E.L. EACH ACCIDENT
$ 1,000,000
EMPLOYERS' LIABILITY
E.L. DISEASE - EA EMPLOYE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,0001000
OTHER
S
S
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
GhK 111-IGA I t MULULK I I ADDITIONAL INSURED; INSURER LETTER: UANULLLA I IUN
RE: 2008 System Improvements Phase 2. 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 ,/I
USA `/!/i
ACORD 25S (7197) holly22
13283965
Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600
ACORD CORPORATION 1988
F
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)
L