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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (103)9/24/2013 12:29 Remote ID Remote ID 1/2 Fax City of Fort Collins TO : Fax: 1-970-221-6707 Attn: James B. 0- Neill Hydro Construction Company, Inc. FROM Phone: IMA, Inc. - Colorado Division Agency: Phone: 1-303-534-4567 Subject: 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 to Ebix EDO and the party responsible for bringing you this information - Certificate Delivery by CertificatesNow - w .ConfirmNet.com - 877.669.8600 9/24/2013 12:29 Remote ID Remote ID 2/2 AFRO® CERTIFICATE OF LIABILITY INSURANCE 09/24/2013 D09/24ATE IDDI13 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 endomement(s). PRODUCER 1-303-534-4567 IMA, Inc. - Colorado Division CONTACT NAME: PHONE FAX AIC No Ext: AIC No: E-MAIL ADDRESSdeR am$SmaCO .COm : P rP 1550 17th Street Suite 600 Denver, CO 80202 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: PHOENIX INS CO (Travelers) 25623 INSURED INSURER B. TRAVELERS PROP CAS CO OF AMER 25674 Hydro Construction Company, Inc. INSURER C: PINNACOL ASSUA 41190 INSURER D: 301 Bast Lincoln Avenue INSURER E: Fort Collins, CO 80524 INSURER F : COVERAGES CERTIFICATE NUMBER: 35866567 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 UBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMBS A GENERAL LIABILITY DTC08743RO16PHX13 09/30/1 09/30/14 EACH OCCURRENCE $ 1.000.000 'Y COMMERCIAL GENERAL LIABILITY ETORENTED PREMISES PREMISES Ea occurrence $ 300,000 CLAIMS -MADE Ix I OCCUR MED EXP (Any one person) $ 10,000 X PD Ded:$5,000 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY DT8108743RO16TIL13 09/30/13 09 30 14 BINEDaccidenf SINGLE LIMIT 1,000,000 Ea $ BODILY INJURY(Perperson) $ 'Y ANY AUTO ALL OWNED SCHEDULED BODILY I DRUB V(P er a cc,denh $ AUTOS AUTOS PROPERTY DAMAGE $ X NON -OWNED X HIRED AUTOS AUTOS Per accident $ B X UMBRELLA LIAB X OCCUR DTSMCUP8743RO16TIL13 09/30/1 09/30/14 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 10, 000 1 1 $ 1 C WORKERS COMPENSATION 2091550 04 01 1 / / 04/01/14 X WCSTATU- DTH- TORV LIMITS ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACC I DENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ NIA E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory in NH) If yes, describe order DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 texts 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 / �'`q /�'�// USA t ��/�,t ACORD 25 (2010/05) SDZM 35866567 © 1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD