HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (2)YSt6uIpYJ1
A� CERTIFICATE OF LIABILITY INSURANCE D09 19/2012
as/19/2o1z
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. N 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
NAME:
IWA, Inc. - Colorado Division PHONE FAX
-LY$.NP.EFIF TAIL No):
1550 17th Street EMAIL
ADDRESS:
Suite 600
Denver, CO 80202 (I �S INSURER(S) AFFORDING COVERAGE NAICp
\,i3
INSURED
Hydro Construction Company, Inc.
301 Mat Lincoln Avenue
Fort Collins, CO 80524
INSURERA: TRAVELERS IMD CO 25658
INSURER B: TRAVELERS PROP CAS CO OF AMER 25674
ivaioeo e. PINNACOL ASSUR 41190
rnvpPArsGg rFRTIFIrATF NIIMRFR- 29132855 RFVISION NUMRFR-
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.
INGR
nr
ADDLTYPE
POLICY EFF
POLICY UP
R
OF INSURANCE INSR Wi
POLICY NUMBER
MMKdDNYYY
MM` DDIYYYY
LIMITS
A
GENERALLABILITY
DTCO8743R0161ND11
09/30/1
09/30/12
EACH OCCURRENCE
$ 1,000,000
X
DAMAGE TO RENTED
300,000
COMMERCIAL GENERAL LIABILITY
PREMISES (Ear cccmmence)
$
CLAIMS -MADE I X OCCUR
MED UP(Any me remand)
$ 10,000
X PD Ded:$5,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMPIOP AGG
S2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO LOG
S
B
AUTOMOBILE LIABILITY
DT8108743RO16TIL11
09 3 /1
09/30/12
COMBINED SINGLE UMIT
(Ee accident)
S 1,000,000
X ANY AU IO
BODILY INJURY (Per demon)
S
BODILY INJURY(Par accident)
$
ALL OWNED SCHEDULED
_ AUTOS AUTOS
NON OWNED
X X
PROPERTY DAMAGE
Peracced,t
$
_. HIRED AUTOS AUTOS
$
B
X UMBRELLA LAB % OCCUR
DTSMCUP8743RO16TILll
09/30/1
09/30/12
EACH OCCURRENCE
S 1,000,000
EXCESS LAB CLAIMSMAOE
AGGREGATE
S 1,000,000
GOO IX RETENTIONS 10, 000
S
C
WORKERS COMPENSATION
2091550
04/01/1
04/01/13
X WC IMIT OTR
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT
5 1,000,000
OFFICERIMEMBER EXCLUOED7 NIA
❑
(Mandatory In NN)
EL DISEASE - EA EMPLOYEE
51,000,000
II es as ride under
DESCRIPTION OF OPERATIONS at
E. L. DISEASE -POLICY LIMIT
S 1,000,000
DESCRIPNONOFOPERATIONSILOCATIONSIVERICLES IAltach ACORD 101, Additional Ramarks ScheaNb, if mom spats is Muirid)
ME: Sob #12-01-274 / D%U.F - Primary Clarifier Repair and Lighting Replacement
City of Fort Collins is included as Additional Insured on the General 6 Automobile Liability Policies if required by
written contract or agreement 6 with respect to work performed by Insured subject to the policy terms 6 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.
700 Wood Street AUTHORIZED REPRESENTATIVE /(1 ./
Fort Collins, CO 80522 USA r///'
!�/� aS SGRA-7ntn ar.nRn rnRP0RATION All .inHte mmrvnH
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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29132855