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Home My WebLink About109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (61)ACORQ. CERTIFICATE OF LIABILITY INSURANCE 0/07 2010Y) 10/07/2010 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: Travelers Indemnity Company INSURER B: Travelers Property Casualty Co of America INSURER C: Pinnacol Assurance 301 East Lincoln Avenue INSURERD: 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 LIMITS A GENERAL LIABILITY DTC08743RO16IND10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $ 300 , 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FxI OCCUR MED EXP (Any one person) $ 10 , 000 PERSONAL BADVINJURY $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 LOC B AUTOMOBILE LIABILITY ANY AUTO DT8108743RO16TIL10 - 09/30/10 09/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 1 , 000 , 000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X BODILY INJURY (Per accident) $ HIREDAUTOS 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 DTSMCUP8743RO16TIL10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 X OCCUR CLAIMS MADE AGGREGATE $1,000,000 $ DEDUCTIBLE $ X RETENTION $10 , 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2091550 04/01/10 04/01/11 X WCSTATU- OH- LIMIT ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 ' E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER a a $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/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 and with respect to work performed by Insured subject to the policy terms and conditions. ty of Fort Collins 300 W. LaPorte Ave. Fort Collins, CO 80522-0000 USA 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. AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) mijaczek 17830844 L- 0 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. ACORD 25-5 (7197) 3:4 F ACORQ, CERTIFICATE OF LIABILITY INSURANCE ° NY) 10/07/2007/2010 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: Travelers Indemnity Company INSURER B: Travelers Property Casualty Co of America 301 East Lincoln Avenue INSURER C: Pinnacol Assurance INSURERD:OneBeacon America Insurance Company 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 DATE (MMIDD/rn POLICY EXPIRATION DATE IMMIDDIM LIMITS A GENERAL LIABILITY DTC08743RO16IND10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 FIRE DAMAGE Any one fire) $ 300 , 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I X I OCCUR MED EXP Any one person $ 10 , 000 PERSONAL BADVINJURY $1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 r 000 , 000 POLICY X PRO LOC B AUTOMOBILE X LIABILITY ANY AUTO DT8108743RO16TIL10 09/30/10 09/30/11 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 DTSMCUP8743RO16TIL10 09/30/10 09/30/11 EACH OCCURRENCE $2,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 2, 000, 000 $ DEDUCTIBLE $ X RETENTION $10 , 000 C WORKERS COMPENSATION AND LIABILITY 2091550 04/01/10 04/01/11 X TV CSTATU- ETH- LIMEMPLOYERS' E.L. EACH ACCIDENT $1,000,000 E.L- DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,00o D OTHER Installation Floater 7100302020000 09/30/10 09/30/11 Per Disaster $ 1,000,000 SPC Form $1,000 Ded. Any 1 Location $ 1,000,000 *Flood/Earthquake *$1,000,000 Sub -Limit *$25,000 *Ded. Temp/Transit $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/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 and with respect to work performed by Insured subject to the policy terms and conditions. ULK I IrIGA I t MULULK I I ADDITIONAL INSURED; INSURER LETTER: GANGELLATION 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 P. 0. Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE I USA (/ ACORD 25-S (7197) mijaczek 17830798 L- O 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) 3:4 F ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE 7 /YY) 10/0/20/2010 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: Travelers Indemnity Company INSURER B: Travelers Property Casualty Co of America INSURER C: Pinnacol Assurance 301 East Lincoln Avenue INSURERD: 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 DATE (MMIDDrrn LIMITS A GENERAL LIABILITY DTC08743RO16IND10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $ 300,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FxI 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 1-1 POLICY X PRO LOC B AUTOMOBILE X LIABILITY ANY AUTO DT8108743RO16TIL10 09/30/10 09/30/11 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 DTSMCUP8743RO16TIL10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 X OCCUR CLAIMS MADE AGGREGATE $1,000,000 $ DEDUCTIBLE $. X RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2091550 04/01/10 04/01/11 STATU YLIM-C X WER 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 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins and MHW are 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. UhK 111-JUA I h HULUtK I I ADDITIONAL INSURED; IN RE: Mulberry Intermediate Replacement Proj City of Fort Collins PO Box 580 Fort Collins, CO 80522-0000 USA ACORD 25-S (7197) mijaczek 17830846 L- 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. AUTHORIZED REPRESENTATIVE o 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. AGORD 25-5 (7197) 3:4 L