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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE9/27/2012 12:37 Remote ID Imprint ID D 1/2 Fax City of Fort Collins TO : Fax: 1-970-221-6707 Attn: James B. O'Neill Hydro Construction Company, Inc. FROM Phone: IMA, Inc. - Colorado Division Agency: Phone: 1-303-534-4567 Sub3e-ct: Delivery by CertificatesNow If you have questions regarding the content of this document, please contact the Producer/Agent listed on the certificate of insurance. cc: The data included in this notice and in the attached document is confidential tc Ebix BPO and the party responsible for bringing you this information. Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600 9/27/2012 12:37 Remote ID Imprint ID 2/2.. ACORO® CERTIFICATE OF LIABILITY INSURANCE �. DATEI 7/2 /2012 09 /27 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 IMA, Inc. - Colorado Division CONTACT NAME: PHONE FAX A/C No Ext : A/C, No): E-MAIL ADDRESS: 1550 17th Street Suite 600 Denver, CO 80202 INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: TRAVELERS IND CO 25658 INSURED INSURERS: TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER : PINNACOL ASSUR 41190 INSURER D: 301 East Lincoln Avenue INSURER E: Fort Collins, CO 80524 INSURER F COVERAGES CERTIFICATE NUMBER: 29296243 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 LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY DTC08743RO16IND12 09/30/1 09/30/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 CLAIMS -MARE 1XI OCCUR MEB EXP(Any one person) $10,000 X PE, Ded:$5,000 PERSONAL &ADV INJURY 1,000,000 $ GENERAL AGGREGATE $ 2,000,000 ITAGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMP/OPAGG $2,000,000 _7 PEO LOC POLICY X JF $ B AUTOMOBILE LIABILITY DT8108743RO16TIL12 09 30 1 09/30/13 COMBINED SINGLE LIMIT Ea accident)$ 1, 000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X X NONOWNEDPROPERTY HIREDAUTOS AUTOS DAMAGE Per accitlent $ B X UMBRELLA LIAB X OCCUR DTSMCUP8743RO16TIL12 09/30/1 09/30/13 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 EXCESS LIAB CLAIMS -MADE LED X RETENTION$ 10, 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ N/A 2091550 04 01 1 / / 04/01/13 X WC STATU- OTH- TORV LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 EL DISEASEEAEMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASEPOLICYLIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 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. CERTIFICATE HOLDER CANCELLATION RE: P1007 Water Wastewater Treatment & Site Infacture. 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. James B. O'Neill 215 North Mason Streeet AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 /� (//'�,,�,qq & USA C /� ACORD 25 (2010/05) jacksonna 29296243 © 1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD