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HomeMy WebLinkAbout113618 AQUA ENGINEERING - INSURANCE CERTIFICATE (4)A�oRo CERTIFICATE OF LIABILITY INSURANCE 5DATE TE( 2010 PRODUCER Phone: 303-837-8500 Fax: 303-831-5295 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1515 Wynkoop, Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80202 INSURED Aqua Engineering, Inc. 4803 Innovation Drive Fort Collins CO 80525 67i1T/y:71r0X9 INSURERS AFFORDING COVERAGE INSURER A:PL-Travelers Indemi INSURERB:CL Sentinel Insrual INSURERc:PL-Travelers Indeml INSURER D:Hartford Accident f INSURER E: XT, .cnari al ry Tnaiir: i NAIC # 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 LTR ADDT INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM DD POLICY EXPIRATION DATE (MM/DDNYYYI LIMITS A GENERAL LIABILITY 6 8 015 3 8 L 0 91 5/5/2010 5/ 5/ 2 011 EACH OCCURRENCE $ 1 0 0 Q 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX -] OCCUR DAMAGES ( RENTED PREMISES Ea occurrence) $ 1 0 0 0 000 MED EXP (Any one person) $ 10, 000 PERSONAL & ADV INJURY $ 1,000, 000 GENERAL AGGREGATE $ 2 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 000, 000 POLICY j{ PRO- LOC B AUTOMOBILE X LIABILITY ANY AUTO 34UECIS1066 5/5/2010 5/5/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1, 0 0 0, 0 0 0 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG C EXCESS/UMBRELLA LIABILITY XSFCUP6305Y439IND07 5/5/2010 5/5/2011 EACH OCCURRENCE $ 3 000 000 X OCCUR CLAIMS MADE AGGREGATE $ 3 0 0 Q 0 0 0 $ DEDUCTIBLE f $ X RETENTION $10 0 0 0 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ElE.L. OFFICER/MEMBER EXCLUDED? 34WEGKC2 9 04 5/5/2010 5 / 5 / 2 0 11 WC STATU- TORY OTH- X T RY LIMIT ER EACH ACCIDENT $ 1 000, 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 000, 000 E OTHER DPR9683170 5/5/2010 5/5/2011 Per Claim $1, 000, 000 Professional Liability Annual Aggregate $2,000,000 Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS If required by written contract or written agreement, the following provisions apply subject to the policy terms, con ditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ngoing and completed operations under General Liability; and Additional Insured under Umbrella / Excess Liability but my with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies See Attached... UtK I IFIUA I It MULUtK City of Ft. Collins Purchasing Division PO Box 580 Fort Collins CO 80522-0580 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 REPRESENTATIVES. 10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM. AUTHORIZED REPRESENTATIVE A _ __ e i ��► ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 This Certificate of Insurance 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 (2009/01) for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers' Compensation. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability.