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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (76)CERTIFICATE OF LIABILITY INSURANCE DATE I MIDDI 05/171/201'YY11 OS/11/2011 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: IMA of Colorado, Inc. PHONE FAX WC No Exit- A/C No): E-MAIL ADDRESS: 1550 17th Street PRODUCER Suite 600 Denver, CO 80202 CUSTOMER 10 It, INSURERS AFFORDING COVERAGE NAIC # 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: 21139813 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 SUER POLICY NUMBER MMIDDPOLICY EFF MM/DDPOLICY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F�I OCCUR X PD Ded:$5,000 DTC08743RO161NDIO 09/30/1 09/30/11 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Es occurtenca $ 300 , 000 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X I PRO- LOC JFCT PRODUCTS - COMP/OP AGG $ 2,000,000 $ R AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS DT8108743RO16TIL10 09/30/10 09/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X $ $ H X UMBRELLA LIAB LIAB X OCCUR CLAIMS -MADE DTSMCUP8743RO16TIL10 09/30/1 09/30/11 EACH OCCURRENCE $ 1,000,000 . AGGREGATE $ 1,000,000 FEXCESS DEDUCTIBLE RETENTION $ 10,000 $ - X $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR(PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED7 F (Mandatory In NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below NIA 2091550 04/01/1 04/01 12 X WCSTATU- I JOTH- ER - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1, 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 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. Re: FCWTF Sanitary Sewer Replacement City 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. 700 Wood Street AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521-0000 /'W USA % ghondrogiannis ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 21139813