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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (4)rur.xuMxc ACC>MY CERTIFICATE OF LIABILITY INSURANCE DATE22/2 012 I 03/2/2 `/. 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 ry REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. O 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 INA, Inc. - Colorado D1viDion PHONE PHONE P (AJC, No. Enb__ Na):___ 1$$0 17t]1 street _ _ ___ ___ _ _MAIL, ___ _ E-MAIL ADDRESS: 7 LU Suite -IN LU Denver6000 80202 1 INSURERS) AFFORD GCDVERAGE 7 NAIC4 TRAVELERS IND CO I25658---- INSURED INSURERA: INSURERS: TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. -- I41190 INSURFRC: PINNACOL ASSUR 301 East Lincoln Avenue INSURER D. I Fort Collins, CO 80524 INSURER E_ _ _ _ _ __ _ _ I INSURER F : COVERAGES CERTIFICATE NUMBER: 26173132 REVISION NUMBER- ­THIS ISTOCERTIFY 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. iADDLiSUBRI IITR I POLICY EFF POLICY E%P TYPE OF INSURANCE POLICY NUMBER MMIDDNEYY MMIDDIYYYY LIMITS A GENERAL LIABILITY DTC08743RO161ND11 09/30/11 09/30/12I EACH OCCURRENCE 1,000,000 X _ _i8 DAMAGE TO RENTED COMMERCIAL GENERA( LIABILITY PREMISES IEo occunen )_ 1. 300, 000 I —- CLAIMSMADEIX OCCUR MED EXP(Any one Persan)_I S 10, 000 X PD ned: $5, 000 8 AD_V INJUR_ Is 1. 000,000 _ _ _ _ __ _PERSONAL GENERAL AGGREGATE 2.000, 000 _ _ GEN'L AGGREGATTE LIMIT APPLIES PER: PRODUCTS - COMPIOP PRAGG $ I E 2. 000, 000 I POLICY [ XIPR6 F 1 LOC I __ B AUTOMOBILE LIABILITY W8108743RO16TIL11 9/30/11 09/30/121 COMBINED SINGLE LIMIT IS 1, 000, 000 _ X_]ANY AUTO (Ea acudenl) _ __ _ BODILY INJURY (For parson) _ $ ALL OWNED GCHEOULED BODILY _ AUTOS AUTOS INJURY (Pei accNem) I $ _ X .X ON OWNED PROPERTY DAMAGE $ _HIRED AUTOS _AUTOS - _ I I $ IS X (UMBRELLA HAS 1OCCUR IMSMCUPB743RO16TIL11 09/30/11 09/30/12 EACHOCCURRENCE S 1,000,000_ EXCESSUAS LCLAIDE AGGREGATEMSMA $ 1, 000,000 _ _ ___ __ DED i X 1 RETENTION $10, 000 C WORKERS COMPENSATION 'LIABILITY 2091550 04/01/12 04/01/13 I WC STATU- OTH- XITORYLIMITS AND EMPLOYERS ANY PROPRIETORPARTNERJEXECUTIVE _ _I_ER _ I 1, 000, 000 OFFICERMEMBER E%CLUOED? N NIA( I E.L. EACH ACCIDENT $ - --- - - E.L. DISEASEEAEMPLOYEE_$ 1, 000, 000 Ugs,dtOryneund II yes, descri0e untlar —"" I$ DESCRIPTION OF OPERATIONS below E.L.DISEASE - POLICY LIMIT 1, 000, 000 I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, Adri ional RemarYa ScNadule, it more apace is rMluned) 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 Came and conditions. City of Fort Collins 300 W. LaPorte Ave. Fort Collins, CO 80522-0000 ACORD 25 (2010105) natasha 26173132 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. USA _ I _ M"\ ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD P53iu4N•rz .acoRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) L 03/22/2012 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 PRODUCER 1-JUJ-534-45 INA, Inc. - Colorado Division 1550 17th Street Suite 600 Denver, CO 80202 INSURED Hydro Construction Company, Inc. 301 East Lincoln Avenue Fort Collins, CO 80524 NAME: —_- PHONE .-- FAX___.___-- (NC,No,Eal):__. _ ___..WC,NaT, E-MAIL ADDRESS: _. _ _- _ _ INSURER(S) AFFORDING COVERAGE _ _ _ NAIC0 INSURER A: TRAVELERS IND CO 25658 INSURER B: TRAVELERS PROP CAS CO OF ANER 25674 INSURERC: PINHACOL ASSUR 41190 INSURER o: ONEBEACON ANER INS CO I20621 INSURER E COVERAGES CFRTIFICATF NIIMRFR- 26178186 RFVISIrflJ MUURFR. THISAS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEENISSUED 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. _ __ _ ___ _____________ _r ______ INSR ADDL SUER' - POLICY EFF POLICY E%P - - LTR TYPE Of INSURANCE POLICY NUMBER MMIDOIYYYY MMIOD(YYYY UNITS A GENERAL LIABILITY DTC08743RO16IM11 09/30/11 09/30/12 EACH OCCURRENCE f 1,000,000 _ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED - S 300,000 PREMISES ocwrre,rz)— _— _ _ J CLAIMS MADE I_X I OCCUR MED ERP (Any one person)_ $ 10, 000 X PD Ded:$5,000 -- PERSONAL S_ADV INJURY f 1, 000, 000 GENERAL AGGREGATE _ S 2. 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER. I PRODUCTS- COMPIOP AGG 2,000,000 POLICY X PHI LOCFrT tt$ f B AUTOMOBILE LIABILITY W8108743RO16TIL11 0930/11 09 30 12 COMBINED SINGLE LIMIT (Eaacaden0_-___. _Lf.?, 000, 000__-_ X I ANY AUTO BODILY INJURY (Per person) f _ ALL OWNED ( SCHEDULED AUTOS AUTOS BODILY INJURY ( ) Per azadenl S _ X _I X _ HIREDAUTOS I AUOTOSWNED I _(PerawMenl)AGE I --I $ - B IX UMBREELLALLIAE X OCCUR I WSMCUP8743RO16TIL11 09/30/11 09/30/12 EACH OCCURRE NCE $ 2, 000,000 CLM ADE� EI AGGREGATE 2, 000, 000 — I 1 OLD XL I RETENTIIO $)10A1000 $ C WORNERS COMPENSATION 2091550 04/Ol/12 Od/Ol/13 WCSTATU- OTH- Xi iORY,LIMITS. I-. I_ER AND EMPLOYERS' LIABILITY YIN f ANY PROPRIETOWPARTNEREXECUTIVE ( E.L.EACH ACCIDENT $ 1, 000, 000 OFFICENMEMBER EXCLUDED? NIA -- — -- --- El DISEASE -EA EMPLOYEE S 1,000,000 (MandatoryInNH) Ifyes, de.,w uW.' I _ -- , _ -- - DESCRIPTION OFOPERATIONS below EL.DISEASE - POLICY LIMIT I$ 1, 000, 000 D Installation Floater 09/30/11 09/30/12 Per Disaster 1,000,000 $1,000 Deductible SEC Porm �7100302020001 Any 1 Location 1,000,000 'Flood/Earthquake a$1,000,000 Sub -Limit '$25,00I *Ded. Temp/Transit 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORDID1,AddiNonal Ramarb ScbadRla, if mon apace lc requlrad) 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 terse and conditions. 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. P. O. Box 580 AUTHORIZED REPRESENTATIVE / /j Fort ColliI US, CO 80524 / /'& USA [[[ r///� © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD natasha 26178186 ' PsanxnxlxN aco CERTIFICATE OF LIABILITY INSURANCE D0, 121IDDIYYYY) L 03/22/2012 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 endorsementfsl. PRODUCER i-aw-va-4ahi I IMA, Inc. - Colorado Division NAME: PHONE _ .I FAX .INC, No. E.t):. _ _ _ _ __. ... _ (AIC, No):. 1550 17th Street E-MAIL Suite 600 ADDRESS:_ Denver, CO 80202 ___ _ _ INSURER(S) AFFORDING COVERAGE __ NAICS _ INSURER A: TRAVELERS IND CO 25658 INSURED INSURERS: TRAVELERS PROP CAS CO OF AREA 25676 Hydro Construction Company, Inc. - - -- ---- - '--- INSURER : PINNACOL ASSUR 4119 d1190 301 East Lincoln Avenue INSURER D__ Fort Collins, CO 80524 INSURERE_ INSURER F: I COVFRAGFS CFRTIFICATF NIIMRFR- 26173137 RFVlclnu MIIMP190. 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. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI 'ADDLI$UBRI'-- POLICY EFF POLICY EXP LTq TYPE OF INSURANCE POLICY NUMBER MMIODIYYYY MMIODIYYYY LIMITS A GENERAL LIABILITY dl'C08743R016IND11 09/30/11 09/30/12 EACH OCCURRENCE $ 1, 000, 000 _ X (_ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PHEMISES(E0 occurrencel__Iq 300, 000 X_I CUIMS MADE I OCCUR MED EXP(Any o_Verson) $10,000 % PD Ded:$5,000 _ PERSONAL B A_OV_ INJURY $ 11000,000 GENEMLAGGREGATE q 2, 000, 000 AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPIOP AGG S 2,000,000 _G�E TNT I X I Pft0 �I I$ POLICY 1 JECT LOC B AUTOMOBILE LIABILITY DT8108743RO16TIL11 09/30 11 09 /12 COMBINED SINGLE LIMIT 1, 000, 000 ___ % ANY AUTO (EaaaiOem) BODILY INJURY (Per person) $__,-_,_ I $ _ �TALL OWNED SCHEDULED AUTOS AUTO$ BODILY INJURY IPer acci0ent) $ . (% IX NON -OWNED - _ PROPERTYDAMAGE $ HIREDAUTOS AUTOS (Peracatlenl).______ B X UMBRELLA LIAR X_ OCCUR DTSMCUP8743R016TILll 09/30/11 09/30/12 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMSMADE AGGREGATE E 1, 000, 000 DED I X RETENTION $ 10, 000 I E C WORKER$COMPENSATION 2091550 04/01/12 O4/Ol/13 WC STATU- OTH- % TORY LIMITS i �_ER. ANDEMPlOVER5'LIABILITY YIN ANY PROPRIETORrPARTNERiEXECUTIVE E.L. EACH ACCIDENT �_S 1,000,000 OFFICERIMEMBER EXCLUDED? N❑ NIA — -_ (Mandatory In NN) E.L. DISEASE- EA EMPLOYEE $ 1, 000, 000 DESCRIPTION OF OPERATION$ Dhow _ E L DISEASE POLICY LIMIT I S 1, 000, 000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additnnal Remarks SCM1etlule, II more apace b n9pintl) 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 terma and conditions. l,CK I Ir ILA Ie FIVLUCR GAINUCLLAIIUN 7MRmer'gencyCGenerator Installation.SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ort ollins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Box 580 It Collins. CO 80522-0000 AUTHORIZED REPRESENTATIVE USA / /,& All rinhts rscprwod ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD natasha 26173137