HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (65)F
ACORQ. CERTIFICATE OF LIABILITY INSURANCE
DATE /07/20 0
1007/2010
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.
INSURERA:Travelers Indemnity Company
INSURER B: Travelers Property Casualty Co of America
301 East Lincoln Avenue
INSURER C:Pinnacol Assurance
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 EXPIRATIONLTR
DATE (MMIDDfYYI
LIMITS
A
GENERAL LIABILITY
DTC08743RO161ND10
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 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)
$
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 I 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- O R
Y 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
E
a
E
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins, Ditesco Project 6 Construction Services, LLC 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.
1;1-- IFIS2Ll MULUtK ADDITIONAL
RE: WTF Miscellaneous Maintenance
City of Fort Collins
700 Wood Street
Fort Collins, CO 80521-0000
ACORD 25-S (7/97) mijaczek
17830856
L-
INSURER LETTER:
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 S
USA (/
O ACORD CORPORATION 1988