No preview available
HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (75)`v �® CERTIFICATE OF LIABILITY INSURANCE DATE 2 1 03/2/20/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER 1-303-534-4567 CONTACT NAME: INA of Colorado, Inc. PHONE FAX NC Noll EMAIL ADDRESS: 1550 17th Street Suite 600 PRODUCER CUSTOMER to Denver, CO 80202 INSURERS AFFORDING COVERAGE NAIL 0 INSURED INSURER A: TRAVELERS IND CO 25658 INSURER B: TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER C: PINNACOL ASSUR 41190 301 East Lincoln Avenue INSURER D: Fort Collins, CO 80524 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20221698 REVISION NUMBER - THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR IMSR Vi POLICY NUMBER POLICY EFF (MMIDONYYY1 POLICY EXP fMMlDDlYYYY)LIMITS A GENERAL LIABILITY DTC08743RO161ND10 09/30/10 09/30/11 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR AMAG TO RENTED PREMISES Es a¢urrence E 300, 000 MED EXP (Anyone person) E 10,000 PERSONAL 4AOV INJURY f 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 POLICY X PRO- LOG $ B AUTOMOBILE LIABILITY ANY AUTO DT8108743RO16TIL10 09 30 1 09/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALLOWNEDAUTOS BODILY INJURY (Par accident) $ XI SCHEDULED AUTOS HIREDAUTOS PROPERTY DAMAGE (Perecedord) $ X $ NON -OWNED AUTOS $ B X UMBRELLA LIAB X OCCUR DTSMCUP8743RO16TIL10 09/30/1 09/30/11 EACH OCCURRENCE E 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ $ X RETENTION $ 10,000 C WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTNE /M OFFICEREMBER EXCLUDED'/ � N/A 2091550 04/01/11 04/01/12 X I WCSTATU- I OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) mtlescnbe under RIPTION OF OPERATIONS bet. E1. DISEASE -POLICY LIMIT E 1,000,000 DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES (Attach ACORD 1e1, Atltlltlanal Remarks Schedule, If mom space, Is required) City of Fort Collins is included as Additional Insured on the General, Automobile, and Excess Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. City of Fort Collins 700 Wood Street Fort Collins, CO 80521 jarair85 ACORD 25 (2009/09) 20221698 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA I //v& 0 r uc ..vv.w nanm auu myu arc rcy rarcrcw war Na to ASV Vrau reserved. 3A `v �® CERTIFICATE OF LIABILITY INSURANCE DATE 2 1 03/2/20/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER 1-303-534-4567 CONTACT NAME: INA of Colorado, Inc. PHONE FAX NC Noll EMAIL ADDRESS: 1550 17th Street Suite 600 PRODUCER CUSTOMER to Denver, CO 80202 INSURERS AFFORDING COVERAGE NAIL 0 INSURED INSURER A: TRAVELERS IND CO 25658 INSURER B: TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER C: PINNACOL ASSUR 41190 301 East Lincoln Avenue INSURER D: Fort Collins, CO 80524 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20221698 REVISION NUMBER - THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR IMSR Vi POLICY NUMBER POLICY EFF (MMIDONYYY1 POLICY EXP fMMlDDlYYYY)LIMITS A GENERAL LIABILITY DTC08743RO161ND10 09/30/10 09/30/11 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR AMAG TO RENTED PREMISES Es a¢urrence E 300, 000 MED EXP (Anyone person) E 10,000 PERSONAL 4AOV INJURY f 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 POLICY X PRO- LOG $ B AUTOMOBILE LIABILITY ANY AUTO DT8108743RO16TIL10 09 30 1 09/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALLOWNEDAUTOS BODILY INJURY (Par accident) $ XI SCHEDULED AUTOS HIREDAUTOS PROPERTY DAMAGE (Perecedord) $ X $ NON -OWNED AUTOS $ B X UMBRELLA LIAB X OCCUR DTSMCUP8743RO16TIL10 09/30/1 09/30/11 EACH OCCURRENCE E 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ $ X RETENTION $ 10,000 C WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTNE /M OFFICEREMBER EXCLUDED'/ � N/A 2091550 04/01/11 04/01/12 X I WCSTATU- I OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) mtlescnbe under RIPTION OF OPERATIONS bet. E1. DISEASE -POLICY LIMIT E 1,000,000 DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES (Attach ACORD 1e1, Atltlltlanal Remarks Schedule, If mom space, Is required) City of Fort Collins is included as Additional Insured on the General, Automobile, and Excess Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. City of Fort Collins 700 Wood Street Fort Collins, CO 80521 jarair85 ACORD 25 (2009/09) 20221698 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE USA I //v& 0 r uc ..vv.w nanm auu myu arc rcy rarcrcw war Na to ASV Vrau reserved. 3A �� CERTIFICATE OF LIABILITY INSURANCE DATE ( 03/2M2/2011 03/22/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 endomement(s). PRODUCER 1-303-534-4567 CONTACT NAME: INA of Colorado, Inc. PHONE FAX NC No: E-MAIL ADDRESS: 1550 17th Street Suite 600 PRODUCER CUSTOMER ID #' Denver, CO 80202 INSURERS AFFORDING COVERAGE NAIC 4 INSURED INSURER A: TRAVELERS IND CO 25658 Hydro Construction Company, Inc. INSURER B: TRAVELERS PROP CAS CO OF AVER 25674 INSURER C: PINNACOL ASSOR 41190 301 East Lincoln Avenue INSURER D: Fort Collins, CO 80524 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20221739 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDLTYPE INSR WVDBUBB POLICY NUMBER MIWDDOYEFF MMMCOYEXP UNITS A GENERALUABILITY DTC08743RO16IND10 09/30/10 09/30/11 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY LIAIMS-MADE r—xl OCCUR AMA TO RENTED PREMISES Ea orcuoenm $ 300, 000 MED EXP (Ar,,me Person) E 10,000 PERSONAL BADV INJURY E 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS 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) $ 11000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (ParavideM) $ 1 SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (PeracddoM) $ X X NON-ONMED AUTOS $ $ B X UMBRELLA LIAR OCCUR DTSMCUPS743RO16TIL10 09/30/1 09/30/11 EACH OCCURRENCE S 1,000,000 rd AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ X $ RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOIYPARTNEPo ECUTIVE N OFFICERIMEMBER EXCLUDED? N❑ NIA 2091550 04/01/11 04/01/12 X WCSTATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, desc Ix under DESCRIPTION OF OPERATIONS MIow E.L. DISEASE - POLICY LIMIT f 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (A1facN ACORD 101, AtltlNlonal Remarks SCMdula, If mom space is required) City of Fort Collins is included as Additional Insured on the General, Automobile, and Excess Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Wood Street AUTHORIZED REPRESENTATIVE Collins, CO 80522 I USA jwelrB5 ACORD 25 (2009109) 20221739 ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3:4 �� CERTIFICATE OF LIABILITY INSURANCE DATE ( 03/2M2/2011 03/22/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 endomement(s). PRODUCER 1-303-534-4567 CONTACT NAME: INA of Colorado, Inc. PHONE FAX NC No: E-MAIL ADDRESS: 1550 17th Street Suite 600 PRODUCER CUSTOMER ID #' Denver, CO 80202 INSURERS AFFORDING COVERAGE NAIC 4 INSURED INSURER A: TRAVELERS IND CO 25658 Hydro Construction Company, Inc. INSURER B: TRAVELERS PROP CAS CO OF AVER 25674 INSURER C: PINNACOL ASSOR 41190 301 East Lincoln Avenue INSURER D: Fort Collins, CO 80524 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20221739 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDLTYPE INSR WVDBUBB POLICY NUMBER MIWDDOYEFF MMMCOYEXP UNITS A GENERALUABILITY DTC08743RO16IND10 09/30/10 09/30/11 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY LIAIMS-MADE r—xl OCCUR AMA TO RENTED PREMISES Ea orcuoenm $ 300, 000 MED EXP (Ar,,me Person) E 10,000 PERSONAL BADV INJURY E 1,000,000 X PD Ded:$5,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS 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) $ 11000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (ParavideM) $ 1 SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (PeracddoM) $ X X NON-ONMED AUTOS $ $ B X UMBRELLA LIAR OCCUR DTSMCUPS743RO16TIL10 09/30/1 09/30/11 EACH OCCURRENCE S 1,000,000 rd AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ X $ RETENTION $ 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOIYPARTNEPo ECUTIVE N OFFICERIMEMBER EXCLUDED? N❑ NIA 2091550 04/01/11 04/01/12 X WCSTATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, desc Ix under DESCRIPTION OF OPERATIONS MIow E.L. DISEASE - POLICY LIMIT f 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (A1facN ACORD 101, AtltlNlonal Remarks SCMdula, If mom space is required) City of Fort Collins is included as Additional Insured on the General, Automobile, and Excess Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Wood Street AUTHORIZED REPRESENTATIVE Collins, CO 80522 I USA jwelrB5 ACORD 25 (2009109) 20221739 ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3:4