HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (5)PszauxPuz
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'`� �® CERTIFICATE OF LIABILITY INSURANCE
05/24/so12 DIDDI
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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(les) 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, Inc. - Colorado Division
CONTACT
NAME:
PHONE FAY
.1A14. N0 fA1I
1550 17th Street
Suite
E-MAIL
ADDRESS:
Denver,, COC80202
INSURERISI AFFORDING COVERAGE
NAKQ
INSURER A: TRAVELERS IND CO
25658
1
INSURED l D
Hydro Construction Company, Inc.
INSURER B: TRAVELERS PROP CAS CO OF AMER
25674
INSURER C: PINNACOL A93UR
41190
INSURER O:
301 East Lincoln Avenue
INSURER E:
Port Collins, CO 8052d
INSURER F:
COVERAGES CFRTIFICATF NIIMRFR- 27258759 RFVIQ,nu MMMRFR-
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.
INSa TYPE OF INSURANCE ADDL SUER POLICY EFf POLICY EXP
Lm POLICY NUMBER IM D MMIDDIYYYY LIMITS
A
GENERAL LIABROY
DTC00743RO16IM11
09/30/1
09/30/12
EACH OCCURRENCE
S 1,000,000
COMMERCIAL GENERAL LIABILITY
_DA%
LEE, EO
PREMISES_L occunence7
PREMISES
S 300,000
MED EXP(Any one Person)
$ 10,000
_ _I CLAIMS -MADE 1�1OCCUR
% PD Ded:$5,000
PERSONAL S ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENt AGGREGATE
LIMIT APPLIES PER:
PRODUCTS-COMPIOPAGG
$2,000,000
POLICY
% PRO'IOC
S
B
AUTOMOBILE
LIABILITY
DT8108743RO16TIL11
09/30/12
COMBINED SINGLE LIMIT
(Ea accident
1,000,000
BODILY INJURY(Perpe.)
S
X
ANY AUTO
ALLOWNED SCHEDULED
AUTOS _ AUTOS
BODILY INJURY (Per acddenl )
$
X
VIREO AUTOS % AUOT OWNED
PROPERTY DAMAGE
LPeracci0enf
$
$
B
%
UMBRELLA LIAR
X_
OCCUR
MSMCUP8743RO16TIL11
09/30/1
09/30/12
EACHOCCURRENCE
$ 11000,000
$ 11000,000
EXCESS LIAR
CLAIMSMADEAGGREGATE
DED X I RETENTIONS 10,000
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PHOPRIETORIPARTNEWEXECUTIVE
PA OFFICEREMBER EXCLUDED? N❑
NIA
2091550
Od/O1/1
Od/O1/1J
WCSTATU- OTH.
X 19RY1IMIIS. _Eft
E.L. EACH ACCIDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
IMandafury In NH)
If yef. denabeM uer
DESCRIPTION OF OPERATIONS rrmov
EL DISEASE POLICY LIMIT
S 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Afnch ACORD 10. MiNflonal Remarks schedule, If more space is re9Ylrsd)
RE: Laporte Ave - Valve Replacement Project.
City of Port Collins is included as Additional Insured on the General and Automobile Liability Policies if repaired by
written contract or agreement and with respect to work performed by Insured subject to the policy terma and Conditions.
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.
Attn: Jay Rose
700 Wood Street
AUTNORgED REPRESENTATIVE
Port Colli�a/
no, CO 80521-0000 / / k
i USA �
®1988-2010 ACORD CORPORATION. All rights reserve
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
mweecce
27258759