HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (11)Pf2Ne2M2
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A6OZ CERTIFICATE OF LIABILITY INSURANCE DATE IYYIOOM YY)
L - o9/2412013
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: H the certificate holder Is an ADDITIONAL INSURED, the pollcy(iss) must be endorsed. It 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 andorsamenttsl.
PRODUCER
IVA, Inc. - Colorado Division
1550 17th Street
Suite 600
Denver, CO 60202
INSURED
Hydro Construction. Company, Inc. �094'2D
301 Rest Lincoln Avenue y/
Fort Collins, M 80526
FAX
(AIQ Nog
danpamOlmaCOrp.C®
WSURER(S)AFFORDWDCDWE U
A; PBOERIX INS 00 (Travelwa)
f: TPAVX14M PROP CM 00 OF MMR
PIN9ACOL ASOUR
COVERAGES CERTIFICATE NUMBER: 35866525 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.
111$R ME OF WSAANCE POLICY MU R POLICY EFF .. POLICY UP LIMIT$
A
GENERAL JAaa2rY
DTC08743RO16PSK13
09/30/1
09/30/14
EACH OCCURRENCE
s 1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMSMADE 1XI OCCUR
_
PA M SE T6 RENTED-
$ 300, 000
MEDEXP "
$2.0,000
Z PD Ded:$5,000
PERSONAL A ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE
UNIT APPLIES PER
pRODUCTS.COMPIOPAGG
$ 2,000,000
POLICY
= PR0 La
$
B
ADTOMOBILE WWIITY
dl'83087d3RO16TIL13
COMBINED SINGLE LIMIT
dent
11000,000
BODILY INJURY(PM posoo)
$
X ANY AUTO
ALLOWNED SCHEDULED
_ AUTOS AUTOS
BODILY INJURY (PwarddNd)
f
_
2 HIRED AUTOS R AUTO
OS
;:X43TYDAMAGE
$
f
B
A
UMBRELLA Use
2
OCCUR
DTMIKMPS7431016SII33
09/30/
09/30/14
EACH OCCURRENCE
$ 3,000 000
AGGREGATE_
$ 1,000,000
EXCESS LIAR
CLAIMS MAOE
DEO 2 [RETENTION$ 10,000
_
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
IWY MOPRIETOWPARTNERIEXECUTIVI,
OFFICERAAEMBER EXCLUDED' Q
MIA
2091550
O6/01/1
04/01/14
R WCSTATLL OTRF
ER
_—
a1,000,000
--'—
E.L. EACH ACCIDENT
E1. DISEASE - EA EMPLOYEE
(MMMMmyInMR)
$1,000,000
uadna uM.
DESCRIPTION OF OPERATIONSbNoo
E.L. DISEASEPOLICYLIMIT
S1,000,000
DESCRIPTOR OF OPERATIONS I LOCATIONS VDNCLES (AIIN0 ACORD 101. AddIl Ramwta Sclwdula, If mom apace M mRukad)
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.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
FC,1y
of Fart Co111ne THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
300 W. LaPorte Ave. AUTHORIZED REPRESEMATIVE /^ /
Fort C011iea, CO 80522-0000 //;�//
USA ✓�/�
C 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
SD=
35866525
I
%]NNEXWl
R, w ATE IMMIODIYYYTI
ACORO CERTIFICATE OF LIABILITY INSURANCE F
D
, 09/2d/2013
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 pollcy(ies) 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 endorsament(s).
PRODUCER 1-303-534-4567 CONTACT
INA, Inc. - Colorado Division NAME. _ _ _ _.
PHONE IF"
W9. He. EMI:
1550 171h Street Ep ES ; denpmWimaO p.D
Suite 600
Denver, CO 60202 __ INSURENgLkIWORDWISCOVERAGE ---MAN:4
INSURER A: PROMS7IX INS 00 (Travelers) 256"
INSURED INSURER a: TRAVXIJW PROP CAB CO OF AMM 25674
Hydro Construction Company, Inc.
INSURER c: PIdeLCOL A880A 11190
301 Best Lincoln Avenue INSURER D:
Port Collins, CO 80524 INSURER E:
INSURER F :
rnVFOAGFS rFRMFIrATF NIIMRFR- 35866529 REVISION NUMRER:
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 REOUIRFMENT, 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.
_
INM TYPE OF NSURMCE OL dUSA POLICY NUMBER -YML OY EFF Po OY EIIP rfm LSMT4
A
OE3BIALLMM.Ry
DTC08743RO16PHX13
09/30/1
09/30/14
EACH OCCURRENCE
$ 1,000,000
X CSMERC GEEILV-LUBILITY
DAMAGEf0
PREMISE
$300, 000
MED EXP .
fAAMgMAm Fil OCCUR
$ 10, 000
PERSONAL 4 ADV INJURY
X PI) Dods WOOD
$ 1, 000, 000
GENERAL AGGREGATE
$ 2, 000, 000
GENI. AGGREGATE
UMIT APPLIES PER
PRDOUCTS- CoMplop AGO
$2,000,000
Pou,
z PRo- LOG
$
B
AUTOMOMz UAMMIT
DT810874311016TIL13
CONFINED SINGLE LIMIT
Esscd oI
1,000,000
—
EDGILY INJURY (PePs.)
8
-.
X ANY AUTO
soDBY INJI1RY(Pa a suaN)
ALLOMED SCHEDULED
AUTOS AUTOS
X HIRED AUTOS H NIT
5
-.
8
PROPERTY DAMAGE
B
i
IINNIFd1AIMA
[I
OCCUR
09/30/1
09/30/14
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
S 1,000,000
EXCESS LW
CLAIMS MADE
�DTBILWO7433LO167XL13
1
DED I Is I RETENTION$ 10, 000
1 $
C
WORNFAs COMPENSATION
AND EMPLOYERS LM&MTY
MYPROPwETORIPARTNERIEXECUTNE YIN
OFFICERMEMBEREXCLUDED9
(MMdMaIY In NH)
NIA
2091550
04/01/
04/01/14
I WC STATU- OTH-
ra
-- -
51,000,000 _
S 1,000,000
E.L EACH ACCIDENT
El. DISEASE -EA EMPL
E.L. DISEASE - POLICY LIMIT
If yu dsFFN6e
OF OPERATIONS OeIpw
DESCRIPTION OF O
i 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (UapII ACORD 101. MOINontl R—m & aduduM, II m spP N I uM)
PCOTICIr ATC Mnl nFR CANCFI I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Opal
P. Dick, CPPO, Senior Buyer
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City
of Port Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
215 North Neaon St, 2nd Floor
Port Colline, CO 80524
AUTHORIZED REPRESENTATNE //^q
//#
USA
ACORD 25 (2010105)
SD=
35B66529
W lU04•ZU1Y AUVRU t,URPUHAI IUM. All rlgma reswVins.
The ACORD name and logo are registered marks of ACORD