HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION - INSURANCE CERTIFICATE (2)A� �® INSURANCE
DD/7011
CERTIFICATE OF LIABILITY
10/24ATE
10/2411
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 INSURERS), 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
INA of Colorado, Inc.
CONTACT _
NAME:
_
PHONE FAX
Mom_
1550 17th Street
Suite
EMAIL
ADDRESS:
c
Denver,, eoao2
CO
INSURERIS) AFFORDWG COVERAGE
NAIC a.
INSURER A: TNAVN JUtS IND CO
25658
INSURED
INSURER B: TIUVBLBN9 PROP CAS CO OF AMER
25674
Hydro Construction Company, Inc.
INSURER C: PINNACOL ASSOR
41190
INSURER D:
301 Beet Lincoln Avenue
INSURER E:
Port Collins, CO 80524
INSURER F :
COVERAGES CERTIFICATE NUMBER: 23761395 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
LM
TYPE OF INSURANCE
ADOL
INSR
SUER
ME)POLICY
NUMBER
POLICY EFF
YYMOIYYYYI
POLICY UP
IMMIDINYYYYi
LIMITS
A
GENERAL LIABILITY
DTC00743RO161NDII
09/30/1
09/30/12
EACHOCCURRENCE
f 1,000,000
E CGMMERCIAL GENERAL LIABILITY
_
CLAJMS-MADE lJ OCCUR
bAMAGEB IkoNTtff ce
PREMIES(Ea Cb
$ 300,000
MED UP (My one o)
f 10,000
PERSONAL S ADV INJURY
$ 1,000,000
X PD Ded:$5,000
GENERAL AGGREGATE
$ 2,000,000
PER,
GENLAGGREG,ITE LIMIT APPLIES PER
PRODUCTS - COMPIOP AGO
$2,000,000
POLICvJECT E PRO-
-
S
B
AUTOMOBYELIMILTY
DT8108743RO16TILll
COMBINEDSINGLE LIMIT
Ea eCCIdMI
1, 000, 000
BODILY INJURY IPw Peen)
f
E
ANY ALTO
ALL OWNED SCHEDULED
AUTOS I I AUTOS
BODILY INJURY IPw 9¢tlenl)
f
PROPERTY DAMAGE
Pw awideM
f
E
E NON -OWNED
HIREGAUTOS AUTOS
f
B
X
UMBRELLA LIAR
X
OCCUR
MSNCUP8743RO16TILII
09/30/1
09/30/12
EACH OCCURRENCE
f 11000,000
AGGREGATE
f 1,000,000
EXCESB LIAR
CLAIMS -MADE
DED I X I RETENTION 10, 000
$
C
WORNERSCOMPENSATION
AND EMPLOYERS' LIABILITY YIN
2091550
04/01/1
04/01/12
X WC STATU- OTH-
E L. EACH ACCIDENT
$1,000,000
ANY PROPRIETORIPARTNENEXECUIVE
OFFICERMEMBER EXCLUDED? N
MIA
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
(YnMMory In NH)
Ilym des be.mW
DESCRIPTION OF OPERATIONS EeIov
E.L.DISEASE-POLICYLIMIT
1 S 1,000,000
DEWMPT OFGPERATMINSILO MNSIVEHN:LES(AWc6ACORDIOI.Aftfiw!Rwledu SCNMUM,NnwnrqubI ulMl
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.
RE: mulberry Redundancy Project Equipment Procurement,
e-MMP-2011-8. ,
City of Port Collins
Link Mueller
700 Wood St.
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.
Arnion rnRDDRATInN All rl .Me ma —A
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
mrkorus
33761395