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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (79)Y5z..us u R n" CERTIFICATE OF LIABILITY INSURANCE D10/03 D011 10/03/]011 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)e). PRODUCER 1-303-534-4567 CONTACT IIIA of Colorado, Inc. _NAME: PHONE FA% ,(AID, No. En):--___luq No)_ _ 17th600 Street E-M ADDRESS,-- suit Butte 600 - -- -----"--"'---- ' Deaver,R CO 80202 _--- --- INSURERS) AFFORDING COVERAGE_ RAID INSURER A: TRAVELERS IND CO 25658 INSURED INSURER B: TRAVELERS PROP CAS CO OF A14ER 25674 Hydro Construction Company, Inc. INSURER CPIHHACOL ASSUR 41190 WSURERD: 301 East Lincoln Avenue _ INSURER E: FOIL Collins, CO 80524 INSURER F: COVERAGES CERTIFICATE NUMBER: 23448969 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. _ NOIWITHSIANUINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WI IH RESPECT TO WHICH IRIS 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. ILTR NSR TYPE OF INSURANCE IRINSR MO ODLISUBR LGYEXP POLICY NUMBER I MMMOMYY I YMIO IYYYY I LIMITS A GENERAL LIABILITY DTCO8743RO161ND1I 09/30/11 09/30/12 EACHOCCURRENCE U 1,000,000 E COMMERCIAL GENERAL AL LIABILITY _f _ DAMAGETORENTED PREMISES (Ep occuen rrce) S 300, 000 t 10,000 S M _ ] CLAIMS % I OCCUR MEDEXPIAny_peraonl_ % PD Dsd: $5, 000 PERSONAL 4 AOV WJURY 1 1,000,000 AGGREGATE 12,000,000 GEN'L AGGREGATE LIMIT APPLIES PER _GENERAL PRODUCTS - COMPIOP AGG 12,000,000 POLICY X I PRO- I LOC— IFCT B AUTOMOBLELIABILITY M8108743RO16TIL11 COMBINEDSWGLE LIMIT _(Ca acaden0 �__ s 1,000,000 s % ANY AUTO BODILY INJURY(Perpemor) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Pereabenl) t % __ HIREDAUTOS % NAON OWNED _ PROPERTY DAMAGEUTOS-- axse — f s B % UMBRELLA LIAR E OCCUR DTSFICUP8743RO16TIL31 09/30/11 09/30/12 EACHOCCURRENCE 0 1,000,000 AGGREGATE $ 1,000,000 _ EXCESS LIAR CLAIN13.1.1N)E DED 1E FRETENTIONS 10,000 $ C NSATION WORKERS AND EMPLOYE MABILIITY YIN 2091550 04/01/1304/01/12 STATU -ER._ %TORY. IMITS s 1,000,000 ANY PROPRIE TORNARTNEWEXECUTIVE❑ OFFICERAIEMBER EXCLUDED) N NIA EL. EACH ACCIDENT _ EL. DISEASE EAEMPLOYEq s 1,000,000 (Myyaeendamry In NH) DESCR4IPTION OF OPERATIONS Uebw E L DISEASE - POLICY LIMIT _ 1 1, 000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAUch ACORO 101, Additional Remains Schedule, IT more Vau Is ra9airedl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE F. Dick, CPPO, Senior Buyer THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN of Fort Collin ACCORDANCE WITH THE POLICY PROVISIONS. North Meson St, ]red Floor AUTHORIZED REPRESENTATIVE / /j Collins, CO 80524 / //.�i' USA ((! a/�//� ©1988-2010 ACORD CORPORATION. All rights reserve) ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD nataeha 23440969 PSldplNXll S `R V CERTIFICATE OF LIABILITY INSURANCE l0/o3/2ou D10/03ATE DDr11 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 ISLA of Colorado, Inc. CONTACT NAME: _ PHONE FAX (AIC. No. E.01_ _Li E-MAIL ADDRESS'__ 1550 17th Street Butte Denver,, COC80203 ____ INSURER(S)AFFORDING COVERAGE NAICX INSURERA: TRAVELERS IND CO 25658 INSURED INSURERS: TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER C: PZNNACOL ABSOR 41190 INSURER D: 301 Best Lincoln Avenue _ INSURER E: Port Collins, CO 80524 INSURER F: COVERAGES CERTIFICATE NUMBER: 23448987 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 REOUIREMENf, TERM OR CONDITIONOFANY 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 I LTR TYPE OF INSURANCE ADDLISUBp POLICY NUMBER MYIODMYY MMIICYEYY LIMITS A GENERAL MWLRY DTCO8743RO161ND11 09/30/1 09/30/12 EACH OCCURRENCE $1,000,000 % _ COMMERCIAL GENERA ICLAIMSMADE (OCCUR _ DAMAGE TO RENTED PREMISES PREMISES(Ea occurrence)__ MEDEXPIMy_perwnl_ 300, 000 f _ S10,000 S 1,000,000 X PD Ded:$5,000 PERSONAL A_A_DV INJURY GENLHALAGGREGAIE S 2,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGO F2,000,000 -- POLICY (X FEO LOC IFCT $ B AUTOMOBILE MBILITY W8108743RO16TIL11 COMBINEDSINGLE UMIT t1,000,000 $ X ANY AUTO BODILY INJURY (Pa Person) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (PP aocowt) S S __ NON MINED X HIRED AUTOS X AUTOS PROPERTY DAMAGE (Per&xeenl)__ B X UMBRELLA JAB X OCCUR MSMCUP8743RO16TIL11 09/30/1 09/30/12 EACH OCCURRENCE S 11000,000 AGGREGAIE $ 1,000,000 EXCESS LIAB CLAIMS IMOE OED I X I RETENTIONS 10, 0 00 $ C WORKERS COMPENSATION ANDEMPLOYERS' LIABILT' ANY PROPRIEIORRARINOUEXECUTIVE YIN OFFICER,U%MBER EXCLUDED? NIA 2091550 04/01/1 04/01/12 XI WC STAID OTH- — TORY DMITS - ER__ EL EACH ACCIDENT $ 1,000,000 - E L. DISEASE - EA EMPLOYE S 1, 000, 000 1114�e F q In NI xsl DESCRIPTIrON OF OPERATIONS Eebw ELDISEASE POLICY LIMIT f 1, 000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Much ACORD 101, Additional RreMMF SNMUM, N mon ap¢r I. rw,WW) City of Port 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. GANIaL1A11LIN DWRP Coatings a Humidification H-WRP-2011-6. of Port Collins Link Wueller 700 Wood St. Port Collins, CO 00521-0000 ACORD 25 (2010105) natasha 23446987 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORNEO REPRESENTATIVE Lip" // 10 The ACORD name and logo are registered marks of ACORD All dnhls raaorvad l:lr ur. —