HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION - INSURANCE CERTIFICATEPSEwluExueE
A� �® CERTIFICATE OF LIABILITY INSURANCE
O12/02/201YY)
1a/Da/moll
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
PHONE I1r FNf
(A/C, No.
1550 17th Street
Suite 600
E#I)AIL
ADDRESS'
Denver, CO 80202
_____INSURERS) AFFORDING COVERAGE
_NAICI
INSURER A: TRAVELERS IND CO
25658
INSURED
Hydro Construction Company, Inc.
INSURERS: TRAVELERS PROP CAS CO OF AMER
_ _---------
25674
'
INSURER C: PINNACOL ASSUR
41190
INSURER
301 East Lincoln Avenue
INSURER
Fort Collins, CO 80524
INSURER F
U t,KIIFIUA1t NUMBER: Le.t1]U2U
9 yYl LVbI: ■!111 r,19SD
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 TADDLISUBR I POLICPOLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER MMIDDY EYFFY I MMIDDflYYY LIMITS
A
GENERAL LIABILITY
X
_ COMMERCIAL GENERAL LIABILITY
CLAIMSMADEOCCUR
DTC08743RO16IND11
09/30/11
09/30/12
_EACH OCCURRENCE
NTED
PREMSES(GE ToEa aavnmce)_
NED EXP(Any meperson)
f 1, 000, 000
$ 300, 000
_
f 10, 000
X PO Ded:$5, 000
PERSONALS ADVINJURY
g 1, 000
_
GENERALAGGREGAIE
_
$ 2,000,000
GEMLL AGGREGATE LIMIT APPLIES PER :
PRODUCTS-COMPIOPAGG
I S 2,000,000
POLICY X PRO, ICI LOC
FrT
Is
B
AUTOMOBILE
LIABILITY
M8108743RO16TILII
COMBINED SINGLE LIMIT
(Eaaaidon, __$
1,000,000
$
X
ANY AUTO
BODILYINJURV IPCr person)
AUTOS SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per eccdem)
$
X
HIRED AUTOS X AUTOSWNED
X
PROPERTY DAMAGE
$
s
B
X
(UMBRELLA LIAR
II �yr
�.I
MSMCUP8743RO16TILI1
09/30/11
09/30/12
_EACH OCCURRENCE _If
11000,000
EXCESS LIARS
OCCUR VADE
l
AGGREGATE I�
1, 0001000
j
�DED
I X RI ETENTION $ 10,000
C
WORKERS COMPENSATION
AND EMPLOYERTUABILUY YIN
ANY PROPRIETOR EXCLUDED?
EXCLUOEDi O
OFFICEtoq
NIA
2091550
D4/DI/u
o4/o1/1z
WC STATU- I OTR-
IORY LIMITS(—L EB'j
E 1, 000, 000
H1, EACH ACCIDENT
EL DISEASE EA EMPLOYEE$
1, 000, 000
In NH)
Ifyes,dory In NHI
EL DISEASE -POLICY LIMIT 1
--
s 1, 000, 000
Nenter
DESCRIPTION
D[SCRIPTIONOFOPERATIDNStmbw
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Mtach ACORD 101, AddlDonal smocks Schedule, N mom apace is nquimd)
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. A Waiver of
Subrogation is provided in favor of Additional Insured on the Workers Compensation 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: DWRF - Mulberry Redundancy (NPT Improvements)
JObk 12-01-250.
City of Fort Collins
100 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
O 1988-2010 ACORD
rinhm men,vnA
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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24313820