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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (6)PSI61M2CWl g ''� oM CERTIFICATE OF LIABILITY INSURANCE O10/03ATE IO011 1 to/o3/sou 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 co REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iss) 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 IAA Of Colorado, Inc. CONTACT NAME! p T PHONE FAX _IAIO No. Fall:_ --_ _ LIAID, No1:_______ EMAIL AD_D_RESS: 1550 17th Street Z LLl Ilanver, co ecaoa 1, _ VL_ fl _ ``1{1{ _Y INSURER(e)AFFOROING COVERAGE _ _ NAlctl _____ INSURER A: TRAVELERS INO CO 25658 INSURER B: TNVELERS PROP CAB CO OF AMER 25674 1(O/'J1ll�i INSURED l `c'1 VV Hydro Construction Company, Inc. INSURER C: PIHNACOL ASSUR 41190 INSURERD: 301 Seat Lincoln "erne INSURERE__ Fort Collins, CO 00524 INSURERF: COVERAGES CERTIFICATE NUMRFR: 23448967 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 ADDLSUBR POLICY EFF POUCYEXP LTR TYPE OF INSURANCE INSR VAID POLICY NUMBER MMID IYYYY MMIDD YY LIMITS A GENERAL LIABILITY MC08743RO161M11 09/30/11 09/30/12 EACH OCCURRENCE % COMMERCIAL GENERAL LIABILITY CLAIMS MADE I---1 OCCUR _ DAMAGE TO RENTED PREMISES (Eoccurrenw)_ NED EXP(My we Pereon)_ _$1,000,000 $300, 000 $10,000 X PD Ded:$5,000 PERSONAL B ADV INJURY $ 1, 000.000 GENERALAGGREGAIE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $2,000,000 _ POLICY I % PRO-JECT --1 LOC $ B AUTOMOBILE LIABILITY M8108743RO16TIL11 COMBINED SINGLE LIMIT $ 1,000,000 $ ANY AUTO BODILY INJURY (Per P omc) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per modem) $ PROPERTY DAMAGE .(Pa aCSidenl)___ $ % NON OWNED HIRED AUTOS % AUTOS M X UMBRELLA UAB Y OCCUR MSMCUP8743RO16TIL11 09/30/1 09/30/12 EACH OCCURRENCE 51,000,000 _ $ 1,000,000 EXCESS LIAB CLAIMSMADEAGGREGAIE _ DED % I RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER,FXECUTIVE OFFICERddEMBER EXCLUDED? NIA 2091550 04/01/1' 04/01/12 X WC SIT OT& TORY LIMITS. _-ER_- — --___ E I.. EACH ACCIDENT $ 1, 000, 000 - EL. DISEASE-EAEMPLOYE - $ 1r000,000 IMNndatorylnNH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Rwnarlo Sch".1e, H mom s"A. is squired) City of Fort Collins is included as Additional Insured on the General, Automobile, and Excess Liability Policies if required by written contract or agreetllent and with respect to work performed by Insured subject to the policy terse and conditions. : Lime Vault Installation; H-WPF-2011-3. Ly of Fort Collins Wood Street Collins, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMED REPRESENTATIVE //'(^/// USA / / ,# 010AR.9flin Ar.01nn CORpr1RATIGAI All dnMc .v..-ad ACORD 2512010/05) The ACORD name and logo are registered marks of ACORD nataeha 23448967 PSl6WLCWl 8 0 oM D10/03ATE IDDI11 CERTIFICATE OF LIABILITY INSURANCE 1o/o3/adu 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 I)IA of Colorado, Inc. CONTACT NAME: PHONE FAX_ _ _(AIC, Ho. EvL.— _(AIC, No): —_ E-MAIL ADDRESS: 1550 17th Street Suite 600 Denver, CO 80201 __ _ _IHSURER(S)AFFORDING COVERAGE _ NNC/ INSURER A. TRAVELERS IND CO 25658 INSURED INSURER B: TRAVRLENS PROP CAS CO OF AMHA 25674 Hydro Construction Company, Inc. INSURER CPINNACOL ASSUR 41190 INSURER D: 301 East Lincoln Avenue INSURER E: Fort Collins, CO 60524 _ INSURER F: COVERAGES CERTIFICATE NUMBER: 23448972 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 BYPAIDCLAIMS. IN50. AJAR MR POLICY NUMBER ,POLICY EFFPOMLY E%P R TYPE OF INSURANCE MMIDDMYY LIMITS A GENERAL LIABILITY DTC08743ROI6INDll 09/30/11 09/30/12 EACHOCWRRENCE f 1,000,000 Y COMMERCIALGENERAL_LIAUILnY __ -DAMAGETORENTED PREMISES (Ea occunenu:) S 300, 000 CLAIMS MOE X 1 OCCUR NED E%P(My we person)_ S 10,000 PERSONAL A ADV INJURY 4 1,000,000 Y PD Ded:$5,000 GENE_R_nL_AGGREG_ATE i 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER '. PRODUCTS.-COMPIOP AGG 12,000,000 POLICY X PRO- LDC IEIT - _--�-- S ---- B AUTOMOBILE LIABILITY __ W8108743RO16TIL11 COMBINED SINGLE LIMIT IEa accgen0.__ 1,000,000 .4... X ANY AUTO BODILYINJURY (Per perswl $ ALL OWNED SCHEDULED _ AUTOS _ AU105 BODILY INJURY (Per ecciow0 I 9--------- X- HIRED AUTOS X NOTOSOWNED e.,ENenif AMAGE S R Y UMBRELLA LIAR X OCCUR WSMCUP8743RO16TIL11 09/30/1 09/30/12 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIM MADE __ _CLAIMS DED —XI ( RETENTIONS 10, 0 00 4 C WORXERSCOMPEXSAPON AND EMPLOYERS'IUBBITY ANY PNOPRIETOWPARTNEIVEXECUTIVE YIN OFFICERMEMBER EXCLUDED? MIA 2091550 04/01/1 04/01/12 WC STATU- OTH Y TOBY LIMITS--ER- EL EACH ACCIDENT j 1,000, 000 EL. DISEASEEAEMPLOYE S 1, 000, 000 (Mandafaq M NH) If yes, oncose uw. DESCRIPTION OF OPERAT IONS ULHow EL DISEASE -POLICY LIMIT f 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (AWCN ACORD 101, AddiWnW Rwnwts a Nofi N, N mon specs H niquvsdl City of Fort Collin. is included as Additional Insured on the General Liability Policy if reguii'ed by written Contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. L/L1 iL"RR C\/Lei f SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 W. LaPorte kve. AUTHORUED REPRESENTATPE / n Fort Collins, CO 80522-0000 1 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasba 23448972 L W Y5241NI2tlW2 - IMA of Colorado, Inc. 1550 17th Street Suite 600 Denver, CO 80202 Electronic Service Requested MIXED ADC 800 970 3.5562 MB 1.232 Ir�llrlr��ll�trrl�l�llllllr�lll��ll�l���"III��'Illllrll'�I'Il'11 City of Fort Collins 62 700 WOOD STREET FORT COLLINS, CO A0521-1945 EBIX BPO If you have questions regarding the content of this document, please contact - the Producer/Agent listed on the certificate of insurance. - The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. Cenificale Delivery by CanificatesNow - www.ConfirmNet.com - 677.669.8600 A 6 o® CERTIFICATE OF LIABILITY INSURANCE D1ATE0/103 2011 Y1 1D/o3/aou 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(iss) 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 IMA of Colorado, Inc. CONTACT NAME:_-_ PHONE ilU( - IAIC, Na,- 1550 17th Street Suite 600 E-YML ADDRESS: ---'-- Denver, CO 80202 __ INSURER(S) AFFORDING COVERAGE _NAICS INSURER A. TRAVELERS IND CO 25658 INSURED INSURERS: TRAVELERS PROP CAB CO OF AMR 25674 Hydro Construction Company, Inc. INSURER L: PINNACOL ASSUR 41190 INSURER D: 301 Mot Lincoln Avenue INSURERS Port Collins, CO 80524 INSURER F: COVFRAGFS CFRTIFICATF NtIMRFR- 23448976 RFVISION NIIMFIFR- 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. L7IPS TYPE OF UISURANCE IADDLISUBR INSIRMAMIPOLICY NUMBER YPFFOUCYEYY� UIDOMOLICYEX WI LIMITS --- A GENERAL LuaILm DT008743RO161MIl 09/30/1 09/30/12 EACH OCCURRENCE S 1,000,000 g DOMMERCW. GENERA LIJUMMY 1CINMSMADE OCCUR _ DAMAGE TO RENTED PREMISESIEaoccu meet_ MEDEXP(Myme F2Mo,j_f S ;00, 000 10,000 Y PD Ded:$5,000 PERSONAL S ADV WJURY 51,000,000 GENERUAGGREGAIE_ $2,000,000 GENL AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMPIOP AGG S2,000,000 POLICY I Y I PRO- LOC $ B AUTOMOBJEUMUIUJTY M8108743RO16TIL11 COMBINED SINGLE LIMITJEii ;1,000,000 $ Y ANYAUTO BODILY INJURY (Per Perm) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per RrcMmO $ _ (PRerO�tle I,AMAGE $ Y HIRED AUTOS Y AHONO NED S B Y UMBRELLA LMB Y OCCUR MSMCUP8743RO16TIL11 09131/11 09/30/12 EACH OCCURRENCE $ 11 BOB, 000 AGGHEWIE S 1,000,000 EXCESSOAS CLAMS MADE 7 NO I a I RETENTIONS 10, 000 S C AND EMPLOYERS' LUMITY YIN ANY PROPRIETORIPARTNER,EYECUTIVE OFFICERJUEMRER EXCLUDED? N❑ NIA '091550 04/01/1 04/01/12 WC Y ORC IMTITS.LI Eft E LEACH ACCIDENT _ $1,000,000 E.L. DISEASE- EA EMPLOYE $1,000,000 IYpAmsamry In Min If OESGWPTIIONOFOPERATIONSce E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONSIVEHICLES (Almch ACORD 101, M4NmnY Rrnwl SGIMu%, N man"cr Ic IpuIMJ City of Port Collins is included as Additional Insured on the Geoeral Liability Policy if required by written contract or agreement subject to the policy terms and conditions. Replacement of existing process equipment. of Port Collins Wood Street Fort Collins, CO 80524 USA LFTLGLr19P1V 01Ji SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988-2010 ACORO CORPORATION. All dnhtR ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD netaeba 23448976 Ae6RH CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE DATE 10/03/2011 10/03 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 terns 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 ILIA of Colorado, Inc. CONTACT NAME:-- PHONE FAX (AJL. No. E.W. �LuC.J 1550 17th Street Santa 600 WAIL ADpRESe: CODenver,C80202 ____ INSURE RIS) AFFORDING COVERAGE NAICF INSURER A: TRAVSLHRS IND CO 25658 INSURED INSURER B: TRAVSLeRS PROP CAS CO OF ANRR 25674 Hydro Construction Company, inc. INSURER L:_ PINNACOL ASSDR 41190 INSURER 0:_ 301 Mat Lincoln Avenue INSURER E: Port Collins, CO 60524 INSURER F: COVERAGES CERTIFICATE NUMBER: 23448978 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 RrEDUCED BYYPPAID CLAIMS. WSW' IAOW IWVO POLICY HIMBER PHI-- ( YYIWYYYYYI LIMITS TR TYPE OF INSURANCE A GENERALLUL&LITY UTC08743RO161ND11 09/30/11 09/30/12 EACH OCCURRENCE 5 1,000,000 X COMMERCIA-GENERALLIABILITY _ _PREMISES CLAIMSMADE 17I OCCUR -DAMAGE TOREMED LEzou rreMej_ 5 300,000 MEDEXPIMymaperonl_ 110,000 X PD Ded:$5,000 PERSONAL 4 ADV INJURY $ 1,000,ODO GENEHALAGGREGAIE 5 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER _ PRODUCTS -COMPIOP AGO S2,000,000 � POLICY X PRO- LOC S B AUTOMOBAE LIABIU`TY UT8108743RO16TIL11 09 ( OD OMBINEEDI, INGLE LIMIT 11, 000, 000 S x ANY AUTO BODILY INJURY(Por person) ALL OWNED SCHEOULEO AUTOS AUTOS _ _ BODILY INJURY (Pm aaiOmQ S PROPERTY DAMAGE (Per uaMent) S NON OWNED X HIRED AUTOS X — AUTOS 5 B X UMBRELLALMB X OCCUR MSMCUP8743RO16TILII 09/30/13 09/30/12 EACH OCCURRENCE $ 1,000.000 AGGREGATE_ $ 1,000,000 EXCESS LIMB__ _ CLAIMS MADE F I DED X RETENTION $10, 000 C WORXERS COMPENSARON ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETORPARINEREXECUTIVE OFFICERIMEMBER EXCLUDED? N❑ NIA 2091550 04/01/1 04/01/12 X WC LIMITTAID LR- TDRY LIMIT ER_ 11,000,000 E.L. EACH ACCIDENT - — EL. DISEASE - EA EMPLOYEE $ 1,000,000 IMandamrinMR) I(ye desrnhenmm DESCRIPTION OF OPERATIONS hebw E.L. DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Mach ACORD 101, AddWomd RwwAs Schodub, It more apace Is requirW l 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 teras and conditions. 6t=K 1 WMA I C MULUCK UANOCLLA I IUK RR: Intake Generator Replacement. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street AUTHORIZED REPRESENTATIVE / /% Port ColllUSA 111 s/�/(� /` ,�i, na, CO 80521-0000 / (cT laRAS01n arrupn CflpprIPATIr1N all .in Ma men,vnH ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasha 23448978 Aco a CERTIFICATE OF LIABILITY INSURANCE D10/03/201VY) 10/03/2011 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(ios) 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 IRA of Colorado, Inc. CONTACT NAME:------- _________ PHONE FAY .LAIC. No. E.ti--_— 1550 17th Street suite 600 EMAIL ADDRESS' -- Denver, CO 80202 _____ INSURERS) AFFORDING COVERAGE _NAICi_ INSURER A: Tom_ VELRRS INTO CO 25658 INSURED INSURERS: TRAVELERS PROP CAS CO OF ANER 25674 Hydro Construction Company, Inc. INSURER C: PINHACOL ASSUR 41190 INSURER O: 301 Nast Lincoln Avenue INSURER E: Fort Collins, CO $0524 INSURER F : COVERAGES CERTIFICATE NUMBER: 23448979 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 BY PAID CLAIMS. REDUCED INSRI IyPE OF INSURANCE ADDLISUBR POLICY NUMBER YMMDMYLICTEFF POLICYEYP INSIR VIVOMMID IYYYY LIYli9 A GENERALUMBRITY DTCO8743R0161N011 09/30/1 09/30/12 EACHOCCURRENCE S 1,000,000 x COMMERCIAL GENERAL LIABILITY C"NS-MACE -- 1 OCCUR _ DAMAGE TO RENTED _ PREMISES occurrence)_ NED EXP(My one Person)_ $ 300, 000 $ 10,000 X PD Ded:$5,000 PERSONAL a ADV INJURY S 1,000,000 GENIL UAGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER _ PRODUCTS � COMPIOP AGG $2,000,000 POLICY rX PRO- LOG S B AUTOMOBILE LIABILRY DT8108743RO16TILII COMBINED SINGLE OMIT _(Ea acdpepq 11,000,000 $ Y ANY AUTO BODILY INJURY (Pu Person) ALLOWNED SCHEDULED AUTOS BODILY INJURY (Pw ecoRot) $ PROPERTY DAMAGE $ YAUTO 1ROON OWNED HREDSAUTOS X I S B Y UMBRELLA LIAR E OCCUR MSMCUP8743RO16TIL11 09/30/1 01/30/12 EACH OCCURRENCE S 1,000,000 AGGREGATE $ 1,000,000 EXCESS LI�AB CLAIMS MADE DEC I Y RETENTIONS 10,000 $ C WORKERS COMPENSATION AND EYPLOYERS'LUtBLLITY YIN ANY PROPRIETOBIPARTNEWEXECUTIVE OFFICER WEMBER EXCLUDED, h NIA 2091550 04/Ol/11 04 /Ol/12 WC STATU- OTH Y �ORYLI..TS _ER. E L. EACH ACCIDENT __ $ I. no. no — EL. DISEASE - EA EMPLOYE $ 1:000,000 (MarWatarylnNH) V Yes.d Te urge DESCRIPTION OFOPERATIONS hebw E.L. DISEASE -POLICY LIMIT --- S 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(Aeach ACORD let, AdddkNud RFinarka ec 14, Nmom ,an M PFuwxI) 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: NWRP Communication and Security Project. of Fort Collins 100 Wood Street Collins, CO 80521-0000 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORHED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasha 23448979 PSE611UEnUE DTE DDI CERTIFICATE OF LIABILITY INSURANCE 10/03/]O11 30/03 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(iss) 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 a . PRODUCER 1-303-534-4567 IMA of Colorado, Inc. CONTACT NAME:-- _ _ _ -PHONE FAX WC, NO, EgI:— 1550 17th Street Seize EMAIL ADD_RESa Denver,, COC80107 INSURER(S)AFFORDING COVERAGE __ INSURERA: TRAVRLRRB IND CO _NAICi 25658 WSUREO INSURER B. TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER C: PINNACOL ASSUR 41190 _ INSURER O: 301 Seat Lincoln Avenue _ INSURER E. Port Collins, CO 80524 INSURER F : COVFRAnFS CFRTIFICATF NIIMRFR• 23448983 RFVISION NIIMRFR- 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. ULTR ISR TYPE OF INSURANCE ADDL SUBRI POLICY NUMBER MYMCYEFF [MRM-KIUCIDDYIYYYY LIMITS A GENERALLuas. Y DTC08743R0161N1)11 09/30/11 09/30/12 EACHOCCURRENCE S 1,000,000 Z _ CONMENCwL GENERK LABILITY 'CLAM&MADE 1.1 OCCUR DAMAGE DAMAGE TO RENTED ocwn _ I_ MED EXP(My me Pwa^^)_ S 300, 000 f10,000 PERSONAL d ADV MURY $ 1,000,000 Y PD Ded:$5,000 GENERALAGGREGATE f 2,000,000 _ G ITL AGGREGATE LIMIT APPLIES PER: PROOUCTS- COMPIOP AGG S2,000,000 POLICY X " LOC JECT $ B AUTOMOBILEWLaILJTY W8108743RO16TIL11 COMBINED SINGLE LIMIT 11000,000 r Y ANY AUTO BODILY INJURY (Pa p,X m) ALL OWNED SCHEDULED AUTOS _ AUTOS BODILY INJURY (PIA eaiden) $ PROPERTY DAMAGE .(Pe, axiJ9nq _ S NON-0WNED Y MINED AUTOS Y AUTOS B R UMERELLALIAB I Y OCCUR MSMCUP8743RO16TIL11 09/30/1 09/30/12 EACH OCCURRENCE S 11000,000 AGGREGATE S 11000,000 ""as UAS CLMM&MADE _ _ DED E I RETENDON S 10, 000 S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR)PARTNETUEXECUTIVE OFFICERRAEMBER EXCLUDED? S❑ NIA 1091550 Od/Ol/1 04/01/12 Y WC STATII OTI4 —TORYDMITS —_ER_- EL EACH ACCIDENT $ 1,000,000 ELDISEASE-EAEMPLOYE $ 1,000,000 (MrWamn In NH) If yes wzai eutlr DESCRIPTION OF OPERATIONS iyyA ELDISEASE-POLICYUMIT 51,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AEack ACORD 101, Md"nal RwEulkF S WuM, I mm We* M UquiEMl City of Port Collin. is included as Additional Insured on the General, Automobile, and Excess Liability Policies if required by written contract or agreement aM with respect to work parfotmed by Insured subject to the policy terms and conditions. : Michigan Ditch Pipeline D * Structures. of Port Collins Wood Street Collins, CO 80522 USA 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD latasha 23448983 Y53tlX13nX13 8 R '�R " CERTIFICATE OF LIABILITY INSURANCE O10/03IOOY1 10/03/loll 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(iss) 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 IMA of Colorado, Inc. :_ _ NAMEPHONEFAX (kC.N 1Street E-MAIL ADDRESS' Suit 600 Suite 600 Denver, co e0202 _ INW0.ER3 AFFORDING COVERAGE - - — LI NAICS INSURERA: TRAVELERS IND CO _ 25658 INSURED INSURER B: TRAVELERS PROP CAS CO OF AMER 25674 Hydro construction Company, TOO. INSURER C: PINtUCOL A390R 41190 INSURER D' 301 Met Lincoln AveaUe _ INSURER E: Fort Collins, CO 80524 INSURER F : COVERAGES CERTIFICATE NUMBER- 23448984 REVISION NUMRFR- 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. INSRLTR AWLTYPE OF INSURANCE INSR D POLICY NUMBER POLICY EFF POLICY EXP LIMITS MOLIC YYYY MMIDO A GENERAL LIABILITY DWO8743RO161MIl 09/30/1 09/30/12 EACH OCCURRENCE S 1,000,000 % COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED PREMISES occurrence)_ E 300' 000 _ - CLAIMS MADE I x 1 OCCUR MED EXP (Any me person)_ S 10,000 X PD Ded: $5, 000 PERSONAL A ADV INJURY $ 1, 000, 000 GENERALAGGREGAIE E 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO S2, 000, 000 POLICY x PRO LOC E B AUTOMOBILE LIABILITY DT8108743R016TIL11 COMBINED SINGLE LIMIT (Ea a Ideng______ E1,000,000 f x ANY AUTO BODILY INJURY(Pw person) _ ALL DWNED SCHEDULED AUTOS AUTOS BODILY INJURY IPa eaidenp f x HIRED AUTOS Y AUTOSON OWNED PROPERTY DAMAGE � 1 B X UMBRELLA LIAR x OCCUR MSMCUP8713RO16TIL11 09/30/1� 09/30'12 EACH 11000,000 AGGREGAIE }f E 1,000,000 EXCESSUM __ —DE-0- __ CLAIMS -MADE X RETENTION $ 10, 000 f C WORKERS COMPENSATION ANO EMPLOYERS' LIABILITY YIN ANY VROPRIETORIPARTNEIVEXECUTIVE OFFICER3MEMBER EXCLUDED? MIA 2091550 oa/D1/1 04/ol/1z x WCSTAPLI OTH- TORY-LIMITS—_ER__ E L. EACH ACCIDENT _ f 1,000,000 _ EL DISEASE- EA EMPLOYEE E 1,000,000 (Mar W'In NH) If Yes OasaiCe uMer DESCRIPTION OF OPERA f IONS Wiv. �j EL.DISEASE - POLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AIMCh ACORD IBt, AddiOonal Ramarls SchrdYM, H moM.,. h rpalnd) City of Fort Collins is included as Additional Insured on the General, Automobile, and EXceas Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. RE: Michigan Ditch Pipeline Dpsizing. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street AUTHORRED REPRESENTATIVE nn`�/// Fort Collins, CO 80521 //,& USA [[[[ a/�//` ©1988-2010 ACORO CORPORATION_ All rinhta reserved ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasha 23448984 vsesucNvn 8 R ''R o® CERTIFICATE OF LIABILITY INSURANCE D10/03IDDI11 10/03/7011 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 FAY . WCAQOaxt): _ __I1MC. No): 1550 17th Street E-MAIL ADDRESS'. Suite 600 - -- Denver, CO 80202 _-_INSURER(S) AFFORDING COVERAGE NAIC0 INSURERA: TRAVBLBRS IND CO _ 25658 INSURED INSURER B: TRAVELERS PROP CAS CO OF AVER 25674 Hydro Construction Company, Inc. INSURER C: PIFIHACOL ASSUR 41190 _ INSURER D: 3D1 East Lincoln Avenue INSURER E: Fort Collins, CO 80524 _ INSURER F: COVERAGES CERTIFICATE NUMRER- 23448985 RFVISION NtIMRFR- 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. 5qiLTR� ADDTYPE OF INSURANCE INSR w n POLICY NUMBER I MMMONY FY YYLICYEXP I LIMITS A GENERAL LIABILITY DTC08743RO161NDll 09/30/11 09/30/12 EACH OCCURRENCE S 1,000,000 % _ COMMERCULL GENERALLUBILITY CLNMS-LADE OCCUR DAMAGE TO RENTED PREMISES(Ea occwrenwj_ NED EXP (My one pwwnl_ S 300,000 r 10,000 S 1,000,000 Y PD Ded:$5,000 PERSONAL B ADV INJURY GENERAL AGGREGATE 1 2,000,000 CENT, AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG I2,000,000 POLICY I X I PRP LOC $ B AUTOMOBAEIIABILRY W8108743RO16TILII COMBINED SINGLE UMIT ,(Ea academ)_ j 1,000,000 S MIY gU'0 BODILY INJURY (Pa person) _ qLL OWNED SCHEDULED AUTOS AUTOSON BODILY INJURY (Pw emnem) S % — H.E0AUT08 % it �OOWNEO PRwOP a I, gMAGEm=o _— S r 1 B %— UMBRELLA UAS % OCCUR MSMCUP8743RO16TILII 09/30/11, 09/30/12 EACH OCCURRENCE S 1,000,000 Ir AGGREGATE 11,000,000 EXCESS UAB CLAIMS,MADE DED Y I RETENTIONS 10, 000 / C WORKERS COMPENSATION AND EMPLOYERS' UAIMUTY YIN ANY PROPRIETOR,PARTNERIEXECUTIYE OFFICERMEMBER EXCLUDED? N❑ NIA 2091550 04/01/1 04/Ol/12 WC STATU- JOTI4 Y TORY LIMITS _ -ER _ [L. EACH ACCIDENT S 1,000,000 EL. DISEASE - EA EMPLOYE S 1, 000, 000 IlAmao, M LIN) R ya5, ovicnIle UMw DESCRIPTION OF OPERATIONS boom E.L. DISEASE -POLICY LIMIT r 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHac6 ACERB LOT. Millions! Rammes SchaduN, H mom "p m mquiwdl TUR: Ft. Collins AMI Motors. City of Fort Collins is included an Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to wort: performed by Insured subject to the policy terns and conditions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521-0000 USA 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasha 23448985 NZIIIIIII 0 O a PRNoY*"2 8 Q A� E` CERTIFICATE OF LIABILITY INSURANCE D10/03I2011 T 10/03/2011 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 endorsements). PRODUCER 1-303-534-4567 IIIA of Colorado, Inc. CONTACT NAME: _ PHONE FAX _(AIC,N9.E[0: LINO Nog _ 1550 17th Street Suite E-MAIL ADDRESS: DenVer, , COenveC80202 __ INSURER(S)AFFORDING COVERAGE NNCi INSURER A: TRAVRLIptS IND CO 25658 INSURED INSURER B. TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER C: PIWHACOL ASSOR 41190 INSURER D: 301 Met Lincoln Avenue _ INSURER E: Fort Collins, CO 80524 INSURER F : COVERAGES CERTIFICATE NIIMRFR- 23448988 RFVISION NUMRFR- 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. INS-POUCY UP ErBR e TYPEOFINSURAMCE WSR1ADDLIPOLICY NUMBER Y DCY EFF I MMOMYY LIMIT A GENERAL LMBRITY DTC08743RO161MIl 09/30/1 09/30/12 EACHOCCURRENCE $ 1,000,000 Y COMMERCIAL GENERAL LIABILnY _ ICLINS-MADE n OCCUR -PRMISERENTED _PREMISESSRENT rrence)_ MEDEXP(Vyampweon) $ 300,000 $10,000 Y PD Iled:$5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2, 000, 000 PRODUCTS-COMPIOPAGG $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER POLICY I Y PRO- LUC S B AUTOMOBILE LIABILITY M8108743RO16TIL11 COMBINED BI1OMBINEDDSINGLE LIMIT I11000,000 f Y ANY AUTO BODILY INJURY(P. Person) ALL OWNED SCHEDULED A UTOS _ AUTOS BODILY INJURY (Par aaHenl) $ Y NON OWNED HIRED AUTOS X AUTOS _ PROPERTYDAMAGE (Peraakenlj__ S B Y UMBRELLAUAB Y OCCUR MSHCUP8743RO16TIL11 09/30/1' 01/30/12 EACH OCCURRENCE $ 11000,000 AGGREGATE f 1,000,000 EXCESS LIAR CLAIMS MAIZE DED Y RETENTIONS 10, 000 _ S C WORKERS COMPENSATION AND EMPLOYERS' UABILITY YIN ANTPROPRIEIOR,PARTNEPo XECUTIVE GEEICERIMEMBER EXCLUDED? FNI NIA 2091550 04/01/1 04/01/12 WC STATU- OTH- X TORY LIMITS. — ER_- EEL EACH ACCIDENT 11,000,000 EL DISEASE - EA EMPLOYEE i 1,000,000 (Mandatory In on Ify d,wIxuMar DESCRIPTION OFOPEMHONSSebw _ EL DISEASEPOLICYLIMIT — — S 1,000,000 DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES (AttrcN gLORD 101, AtltllOanM flamarka 9cMatlub, M mon span h rpulM) City of Fort Collins is included ae 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 to. and conditions. 7220 Water/Wastewater Treatment 6 Site Infrastructure Mn/Construction Contractor. of Fort Collins Wood Street Fort Collins, CO 80521-0000 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIIE.D REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasha 23448988 CERTIFICATE OF LIABILITY INSURANCE ATE D10/03/aID011 1o/o111 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(iss) 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 endoreement(s). PRODUCER 1-303-534-4567 IMA of Colorado, Inc. CONTACT _NAME: PHONE IFAX (AIC. He. EFU:._ 1--LAIC Nola_ E-MAIL ADDRESS' 1550 17th Street suite 600 --- - ---- Denver, CO 80202 INSURER(§( AFFORDING COVERAGE NAIC9 INSURER A: TRAVELERS IND CO 25658 125674 INSURED INSURER 8: TRAVELERS PROP CAS CO OF AVER Hydro Construction Company, Inc. INSURER C: PINNACOL ASSOR 41190 INSURER O: _ 301 East Lincoln Avenue INSURER E Fort Collins, CO 80524 _ INSURER F: COVERAGES CERTIFICATE NUMBER: 23448989 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. LEE TYPE OF INSURANCE IAINSA DDLISU D, POLICY NUMBER I MMIDDIYYY I FOLIC Y. LIMITS A GENERAL LIABILITY DTCO8743R016I1VDll 09/30/1 09/30/12 EACH OCCURRENCE f 1,000,000 _ X COMMERCWLGENERALLIABILITY _ DAMAGE TO RENTED PREMISES (Ea occurrence)_ $ 300, 000 $ 10,000 _ l CLAIMS MADE 171 OCCUR MED EXP (My one pawn)_ PERSONAL B ADV INJURY $ 1,000,000 X PD Ded:$5,000 GENERAL AGGREGA It $ 2,000,000 GEN'L AGGREGATE _ LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $2,000,000 I POLICY X PRO- I LOC $ B AUTOMOBILE _ LIABILITY W8108743RO16TIL11 COMBINED SINGLE7UMIT (Ea aceieen9 $ 1,000,000 S X ANY AUTO BODILY INJURY IPerperson) ALL OWNED SCHEDULED AUTOS _ AUTOS BODILY INJURY (Per accMenU $ X HIRED AUTOS X ANOON OWNED PROPERTY eOPPERT If DAMAGE f $ R X UMBRELLA LIAR X OCCUR MSMCUP8743RO16TIL11 09/30/1 09/30/12 EACH OCCURRENCE $ 11000,000 AGGHEGAIE $ 1,000,000 EXCESS LI�AB CLAIMS MADE DED X pETENTION $ 10, 000 § C WORKERS COMPENSATION ANDEMPLOYERS'LMBILITY YIN ANY PROPWETOWPARINEWEFECUTIVE OFFICER4dEMBER EXCLUDED? NIA 2091550 O4/O1/1 04 /O1/12 WC STATUS OTH- X TORY. LIMITS —_ER__ EL EACH ACCIDENT_ S 1,000,000 _ E.L. DISEASE - EA EMPLOYEE - S 1,000,000 HAwdataylnNH) If yes, desolee under DESCRIPTION OF OPERAT IONS 0.E.L.bw EDISEASE -POLICY LIMIT f 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (MW0 ACORD 101, A4ddimal Remarks Bch.dule, It mon ap¢e W n,uind) 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. : Investigation A Potholing of AB Transmission Line of Fort Collins Wood Street Collins, CO 80521-0000 USA 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD nataeha 23448989