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Home My WebLink About109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (67)L- ACOR CERTIFICATE OF LIABILITY INSURANCE DATE7/20 IYY) 10/07MIDDN 10 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 LTRDATE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION IMMIDDIYYI 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 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 LIMITAPPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 RO LOC POLICY X PECT 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-OWNEDAUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS LIABILITY DTSMCUPS743RO16TIL10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 X OCCUR 1-1 CLAIMS MADE AGGREGATE $1,000,000 $ - DEDUCTIBLE $ X RETENTION $10 , 000 C WORKERS COMPENSATION AND 2091550 04/01/10 04/01/11 X I T CRS IMITS1 I ER E.L. EACH ACCIDENT $ i , 000 , 000 EMPLOYERS' LIABILITY E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000. OTHER a a $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/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. CERTIFICATE HOLDER I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION City of Fort Collins Attn: Opal Dick 700 Wood Street Fort Collins, CO 80522 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 O ACORD CORPORATION 1988 17830852 L_ 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 L F■ ACORQ. CERTIFICATE OF LIABILITY INSURANCE DATE 07/20 /YY) 10/7/2010 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 INSURERC: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 (MMIDDNYI LIMITS A GENERAL LIABILITY DTC08743RO16IND10 09/30/10 09/30/11 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire $ 300 , 000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR jXX MED EXP (Any one person $ 10,000 PERSONAL BADVINJURY $1,000,000 PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 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 $1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 $ $ DEDUCTIBLE $ X RETENTION $10 , 000 C WORKERS COMPENSATION AND 2091550 04/01/10 04/01/11 X TWRCY L MITSTATU- O R EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 OTHER S S $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS l:tK I IFIUA I t MULULK I I ADDITIONAL INSURED: INSURER LETTER: UANUIZLLA I IUN al F. Dick, CPPO, Senior Buyer ty of Fort Collins North Mason St, 2nd Floor Collins, CO 80524 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 AUTHORIZED REPRESENTATIVE ACORD 25-5 (7/97) mijaczek 17830845 L 0 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 3:4 L 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. 3:4 L