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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (5)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID EH DATE(MM/DD/YYYY)
ICONE-1 10 07 l0
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Cherry Creek Ins. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suite 500 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5660 Greenwood Plaza Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Greenwood Village CO 80111
Phone:303-799-0110 Fax:303-799-0156
INSURED
ICON Engineering Inc
8100 S Akron Street #300
Centennial CO 80112
COVERAGES
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: The Hartford Insurance Group 22357
INSURER B: Pinnacol Assurance 41190
INSURER C:
INSURER D:
INSURER E:
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.
IN
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2 , 000,000
A
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE L� OCCUR
34SBAPD8771
01/30/10
01/30/11
PREM,SFS(Eaoccurence)
rMED EXP (Any one person) �$
$_300,000
10,000
PERSONAL & ADV INJURY
$2,000,000
GENERAL AGGREGATE
s4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$4r000,000
X7 POLICY JECT PRO LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
34UECTZ5511
01/30/10
01/30/11
COMBINED SINGLE LIMIT
(Ea accident)
$ 1 OOO OOO
r
X
BODILY INJURY
(Per person)
� $
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
X
BODILY INJURY
$
X
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
EMPLOYERIETORI ARITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4077567
02/01/10
r
02/01/11
j X 1 Tf�_Rl' Lf��il_TS!ER
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE -EA EMPLOYEE
$ 100 , 000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 500 , OOO
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Re: 10-028-FCB-415 - Fort Collins Master Plan Hydrology Update Fossil Creek
Basin
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Attn: Susan Hayes
700 Wood Street
Ft. Collins CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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.
ACORD 25 (2001/08) © ACORD CORPORATION 1988
OP ID EH
ACORD CERTIFICATE OF LIABILITY INSURANCE ID ICONE-1
DATE (MMIDDIYYYY)
to 07 to
PRODUCER
Cherry Creek Ins. Agency, Inc.
Suite 500
5660 Greenwood Plaza Blvd.
Greenwood Village CO 80111
Phone: 303-799-0110 Fax:303-799-0156
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
ICON Eng s�neering Inc
8100 S Akron Street #300
Centennial CO 80112
INSURER A: The Hartford Insurance Group
22357
INSURERB: Pinnacol Assurance
41190
INSURER C:
INSURERD:
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.
IN RPOLICY
LT R
NSR
TYPE OF INSURANCE
NUMBER
POLICY
LI Y EFFE TIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 17 OCCUR
34SBAPD8771
01/30/10
01/30/11
EACH OCCURRENCE
s2,000,000
PREMISES (Ea occurence)
$300,000
MED EXP (Any one person)
$ 10,000
PERSONAL &ADV INJURY
s2,000,000
GENERAL AGGREGATE
s4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PROECT LOC
J
PRODUCTS - COMP/OP AGG
s4,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UECTZ5511
01/30/10
01/30/11
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
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
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR F_ICLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERTUTY
ANY PRO PRIEIETCR/OR/PARTNER/EXEC UTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4077567
02/01/10
02/01/11
X TORY LIMITS ER
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$ 100 , 000
E.L. DISEASE -POLICY LIMIT
1 $ 500 , 000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS'
Re: 10-029-MLB-415 - Fort Collins Master Plan Hydrology Update McClellands
Creek Basin
l.th(I 11'II..A I C tIVLUCK L ANL r_LLA I IVI I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins
Attn: Susan Hayes
700 Wood Street
Ft. Collins CO 80521
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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.
J
ACORD 25 (2001/08) © ACORD CORPORATION 1988
OP ID EH
ACORD CERTIFICATE OF LIABILITY INSURANCE ICONE-1
DATE (MMIDDIYYYY)
1 10/07/10
PRODUCER
Cherry Creek Ins. Agency, Inc.
Suite 500
5660 Greenwood Plaza Blvd.
Greenwood Village CO 80111
Phone: 303-799-0110 Fax: 303-799-0156
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
ICON Engineering Inc
8100 S Akron Street #300
Centennial CO 80112
INSURER A: The Hartford Insurance Group
22357
INSURER B: Plnnacol Assurance
41190
INSURER C:
INSURERD:
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.
N
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLI Y EFFE TIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
34SBAPD8771
01/30/10
01/30/11
EACH OCCURRENCE
$2,000,000
PREMISES(Eaoccurence)
$ 300,000
MED EXP (Any one person)
$ 10,000
PERSONAL &ADV INJURY
s2,000,000
GENERAL AGGREGATE
s4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X I POLICY F PROJECT F LOC
PRODUCTS - COMP/OP AGG
s4,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UECTZ5511
01/30/10
01/30/11
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X.
BODILY INJURY
(Per person)
$
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
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4077567
02/01/10
02/01/11
X TORY LIMITS
—
E.L. EACH ACCIDENT
1$ $ 100,000
E.L. DISEASE -EA EMPLOYEE
$ 100 , 000
E.L. DISEASE - POLICY LIMIT
I $ 500 , 000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Re: 10-030-FMB-415 - Fort Collins Master Plan Hydrology Update Fox Meadow
Basin
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Attn: Susan Hayes
700 Wood Street
Ft. Collins CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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.
lLTMMZED REPRESENTATIVE A
ACORD 25 (2001/08) U ACORD GURPORATIUN 19SS
OP ID EH
ACORD CERTIFICATE OF LIABILITY INSURANCE ICONE-1
DATE (MMIDD/YYYY)
1 10/07/10
PRODUCER
Cherry Creek Ins. Agency, Inc.
Suite 500
5660 Greenwood Plaza Blvd.
Greenwood Village CO 80111
Phone: 303-799-0110 Fax:303-799-0156
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
ICON Engsneering Inc
8100 S Akron Street #300
Centennial CO 80112
INSURER A: The Hartford Insurance Group
22357
INSURER B: Pinnacol Assurance
41190
INSURER C:
INSURER D:
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.
INS
LTR
IINSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
IPOLI Y EXPIRATION
DATE MM/DD/YY
LIMITS
A
' -
GENERAL LIABILITY
X COMMERCIALGENERAL LIABILITY
CLAIMS MADE 17 OCCUR
34SBAPD8771
01/30/10
01/30/11
EACH OCCURRENCE
s2,000,000
PREMISES(Eaomalccurence)
$ 300,000
MED EXP (Any one person)
$ 10,000.
PERSONAL BADVINJURY
$2,000,000
GENERAL AGGREGATE
s4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$ 4,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UECTZ5511
01/30/10
01/30/11
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
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
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMSMADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
B
WORKERS COMPENSATION.AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4077567
02/01/10
02/01/11
X TORY LIMITS ER
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$ 100 , 000
E.L. DISEASE -POLICY LIMIT
1 $ 500 , 000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re:10-031-WVB-415 - Fort Collins Master Plan Hydrology Update West Vine
Basin
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Attn: Susan Hayes
700 Wood Street
Ft. Collins CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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.
I ZED REPRESE ATIVE /J
ACORD 25 (2001/08) U ACORD CORPORATION 1988