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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (14)ICONE-1 OP ID: DO 4`oR0" CERTIFICATE OF LIABILITY INSURANCE —DATE D/YYYY) 01111113 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. -v IMPORTANT:..:lf 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 i-------- PRODUCER `J cu- I j I 303-799-0110 Cher 'CreekIris=Af enc ;'Inc_'' n=t Suit 500 g--y --I 303-799-0156 5660 GreenwoodPlaza Blvd.--------- Greenwood Village, CO 80111 Cherry Creek Insurance Agcy _ p O R T CONTACDiane Dimon - _--- NAME:. PNONE "'-` "'FAX'" 1"- ac No E.t,720-212-2066 - - ac-No: 303-799-0156 E MAIL; ADDRESS: DianeD@ thinkcci .com - INSURER $ AFFORDING COVERAGE - NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc `O 8100 South Akron Street #300 Englewood, CO 80112 INSURER B: Pinnacol Assurance 41190 INSURER C: INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUe POLICY NUMBER MM DPOLICY EFF POLICY EXP LTR DIVVVV MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 A X COMMERCIAL GENERAL LIABILITY 34SBAPD8771 01/30/13 01/30/14 PREMISES Ea occurrence) $ 300,00 MED EXP (Any one person) $ 10,00 CLAIMS -MADE OCCUR PERSONAL B ADV INJURY $ 2,000,00 I -_ GENERAL AGGREGATE- $ 4,000,000 LAC'r . GENL AGGREGATE LIMIT'APPCIES PER: __...POLICY -- :PRO-IFCT ._ _t LOC. J ., '"' - -- PRODUCTS - COMP/OP AGG- $='=-.4,000,00 _$ _ -� AUTOMOBILE LIABILITY , , 1 COMBINED SINGLELIMIT Ea accident 11000,000 BODILY INJURY (Per person) -_ $. . AI 'X' ANY AUTO "c 34SBAPD8771 01130/13 01/30/14 BODILY INJURY Per $ ALL OWNED SCHEDULED;'.-,1 AUTOS AUTOS NON -OWNED X HIRED AUTOS M AUTOS �- '. ROPE TY DAMAGE ._ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 4077567 0201113 02/01/14 X WC STATU- OTH- 13YLIM E.L. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED' (Mandatory in NH) N I A E. L. DISEASE - EA EMPLOYEE $ SO0,00 E.L. DISEASE=POLICY LIMIT $ 500,00o It yes. describe Under DESCRIPTION OF OPERATIONS be. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) Re:10-031-WVB415 - Fort Collins Master Plan Hydrology Update West Vine Basin City of Fort Collins Attn: Susan Hayes 700 Wood Street Ft. Collins, CO 80521 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DD ;4�oizo CERTIFICATE OF LIABILITY INSURANCE DATE(M n3YY) 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 t BELOW.. THIS CERTIFICATE OF. INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED I 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 6olAeFiriiieu of"such endorsements : --" - -- - _._ . "" "'-'-" """' _ "' ""',^F �J•" PRODUCER -Age I-.anEl: I I 303-799.0110 Cherry"Creek-Ins..Agency Inc._..___; Suite 500 303-799-0156INC,Na 5660 Greenwood Plaza Blvd. -- "-- ; Greenwood Village, CO 80111 Cherry Creek Insurance Agcy CONTACT NAME:. Diane D'mon- PHONE- '- - FAX Eat:720-212-2066 - ac No) 303-799-0156'�"� ADDBEss: DianeD thinkcci .conl`--` • •--'U" - - INSURERS AFFORDING COVERAGE NAIC Y INSURERA: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER 5: Pinnacol Assurance 41190 8100 South Akron Street #300 Englewood, CO 80112 INSURER C : INSURER D INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDYYVV MMIDDYYYV LIMITS Rzaa GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 X COMMERCIAL GENERAL LIABILITY 34SBAPD8771 01/30/13 01130114 _OAA REMISES(E.o PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 CLAIMS -MADE F OCCUR PERSONAL B ADV INJURY - $ - 2,000,00 _ GENERAL AGGREGATE $ 4,000,00 Li - �_ .-•_ �.. _ -_ - --- GEN'L AGGREGATE LIMIT APPLIES PER ..POLICY •� PRO- r . LOC T., , JECT-AUTOMOBILE PRODUCTS - COMP/OP AGG $ 4;000,00 $ G:.n LIABILITY ._ •- f a;; s= ., _ ... _ COMBINED amideSINGLE SINGLE LIMIT 1,000,00 ,BODILY. INJURY(Per, Person)ALL ANYAUTO "34SBAPD8771 " 01/30/13 01/30/14 BODILY INJURY(Per accident) $AUTOS OWNED. SCHEDULED AUTOS NONOWNED HIREDAUTOS X AUTOS Ix - .".. - -- _-- -- ---- "- - - - - -- PROPERTY DAMAGE Peraccidenl $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION$ $ WORKERS COMPENSATION X I WCSTATU-LIMTj OTH- B AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y❑ 4077567 02/01/13 02/01114 E.L. EACH ACCIDENT $ 500,00 E.L.DISEASE _EA EMPLOYEE $. 500,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH),_ NIA E.L. DISEASE - POLICY LIMIT I S 500,00 It Is., de5RID0 under - DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: 10-030-FMB-415 - Fort Collins Master Plan Hydrology Update Fox Meadow Basin CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN (;1 of Fort Collins City ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Susan Hayes 700 Wood Street AUTHORIZED REPRESENTATIVE Ft. Collins, CO 80521 . AGuan( OI. ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DO '4I�R� CERTIFICATE OF LIABILITY INSURANCE D. 01111/13 Y) 01111/13 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. - - - - t.,IMPORTANT:� If the certificateholder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. IfSUBROGATION IS WAIVED,subject to this certificate does not.confer rights to the the terms and conditions of the policyy , certain policies'marequire an endorsement. A statement on + , _ :._certificate holderin'lieu of such end in PRODUCER ....n �„ , �,.. - .:•.__—_._._. t I' I- i- I 303-799-0110 Cherry:Creek,ins Agency Jnc'-�L, G; Suite 500 -- ___ ___ 303-799-0156 5660 Greenwood Plaza Blvd. Greenwood Village -CO 80111 --------- : Cherry Creek lnsurance Agcy CONTAOT_.'rnn•n- NAME:. 'Diane D mon PHONE (AIC, No Ex1;720-212-2066 __ aC No: 303-799-0156 "- E-MAIL-" `"`•""" "`•'' ADDREss: DianeD thinkcci .corn--'. _ '-,'"rt '.nt ..�.--�- --" INSURERS AFFORDING COVERAGE NAIC N.'...A} INSURER A: The Hartford Insurance Group 22357 •'- - INSURED ICON Engineering Inc 8100 South Akron Street #300 Englewood, CO 80112 INSURER B: PInnacol Assurance 41190 - INSURER C: INSURER D : INSURER E INSURER F COVFRAGFS CFRTIFICATE NUMBER: 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. INTR TYPE OF INSURANCE INSR MAID U9 RPOLICY NUMBER MMIDDIYYYY MM/DDNYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 COMMERCIAL GENERAL LIABILITY 34SBAPD8771 01/30/13 01/30/14 X DAMAA RT.Tun PREMISES Ea occurrence PREMISES 8 300,00 MED EXP (Anyone person) $. 10,00 CLAIMS -MADE OCCUR PERSONAL & ADV INJURY $ - 2,000,00 GENERAL AGGREGATE $ 4,000,000 I11 tr t -- -- GE - NTAGGREGATE LIMITAPPLIES PER'. PRODUCTS-COMP/OP AGO $ 4,000,00 U PRO- POLICY LOC `AUTOMOBILE LIABILITY O; X'C" _ :'sl-r " "-`-` _._•... -•.-.. -__._ _-..__._ _,...r_„ �. COMBINED SINGLE LIMIT Eaaccident _... - $ 1,000,00 A,;.X ANY AUTO �-I'�'^34SBAPD877.1 r.. ., ,01I30/13. .01/30/14 BODILY INJURY (Per person) $ I - ... SCHEDED ULED .' ..1 .. .. ... .. .... " .. _ -•i ._.-`ALL'OVJNED'.-".. _ BODILY INJURY (Pere ccitlenl) -. .- - $ 1° '• ." AUTOS AUTOS.. X PROPERTY DAMAGE Per accitlent $ -, NON -OWNED X - "' - HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTIONS $ WORKERS COMPENSATION X WE STATU- 'ER T NYE IMIT AND EMPLOYERS' LIABILITY Y❑ B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA 4077567 02/01/13 02/01/14 E L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 600,00 (Mandatory in NH) _ -- ' E.L. DISEASE -POUCV LIMIT $ 500,00 , yes. a.6c•ine mde• DESCRIPTION OF OPERATIONS below - - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: 10.029-MLB-415 - Fort Collins Master Plan Hydrology Update McClellands Creek Basin City of Fort Collins Attn: Susan Hayes 700 Wood Street Ft. Collins, CO 80521 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 X ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD