HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (14)PUNAMUD
® DATE (MMIOOGYYYJ
A ACORO CERTIFICATE OF LIABILITY INSURANCE AT I' M2014
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 he 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 CONTACT
INA, Inc_ - Colorado Diviaion NAME:
PHONE FAX
INC,C, Ne, Enl): (AIC. No):
1705 17th Street
Suite 100
Denver, CO 80202
INSURED
Hydro Construction Company,Q Inc.
301 East Lincoln Avenue
Fort Collins, CO 80524
ADDRESS: den amLimcorP•cm
MSURER(5) AFFORDING COVERAGE
HAIC0
INSURER A.
PHOENIX INS CO (Travelers)
25623
INSURER I.
TRAVELERS PROP CAS CO OF AMEN
25674
INSURER C:
PItIIiACOL ASSDR
41190
INSURER D.
ATLANTIC SPECIALTY INS CO (One Beacon)
27154
INSURER E :
COVFRA43FS CERTIFICATE NUMBER- 39097422 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.
INBR SE
TR TYPE OF INSURANCE AODL 6UD POLICY NUMBER
MMIDDNLICY YYY MMN POLICY EXP
D YYY LIMDs
A OeNEset tuanury DT•C04E25124SPHX14
04/01/14 04/01/15 EACH OCCURRENCE
$ 1,000,000
X
DAMAGE TO RENTED
000
COMMERCIAL GENERAL LIABILITY
PREMISES(E. acwnenm)
5300,
CLAIMSANDE X OCCUR
RED EXP(Am ene PeMm)
S10,000
X PD Ded:$5,000
PERSONAL S ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
S 2,ODO,000
GEN'L AGGREGATE LIMIT APPLIES PER.
PRODUCTS - COMPIOP AGO
$2,000,000
POLICY X PRP LOC
$
B AUTOMOSµE LIIiBIl1rY DTB104E216873TIL14
04/01/14 COMBINED SINGLE LIMIT
(Eaa Xen0
$1, 000, 000
X ANY AUTO
BODILY INJURY (Per Person)
$
ALLOWNED SCHEDULED
BODILY INJURY (Per ourted)
$
AUTOS AUTOS
X Y
PROPERTY DUNGE
E
HIRED AUTOS AUTOWNED
(Per a XSNn1)A
8
B X UMBRELLA LIAR X OCCUR DSHCUP4E216873TIL14
04/01/14 04/01/15 EACH OCCURRENCE
s 2,000,000
EXCESS LJA9 CUUMSMADE
AGGREGATE
5 2,000,000
DIED X RETENTION S 10, 000
S
C WORN ERSCOMPENSATION 2091550
04/01/14 04/01/15 X WC STATU- CM+
TORY LIMITS ER
AND EMPLOYERS' LIABIUD YIN
ANY PROPRIETOPo ARTNEWEXECUTIVE
E.L. EACH ACCIDENT
S 1,000,000
OFFICERaAEMBER EXCLUDED' NIA
❑
(MmEMRry In NH)
E.L. DISEASE - EA EMPLOYEE 61,000,000
II OawlEe under
DESCRIPTION OF OPERATIONS OaIow
E.L. DISEASE POLICY LIMIT
$ 1,000,000
D BUILDERS RISE 7100302020004
04/01/14 04/01/15 Per Disaster
$15,000,000
$5,000 Deductible SPC Form
Any 1 Location
$15,000,000
"Flood/Earthquake "$1,000,000 Sub -Limit
"$25,000 "Ded. TeRp Loc/Transit
$100,000
DESCRIPTION OF OP 710113 I LOCATIONS I VEHICLES (Allah ACORD 101. Ad4Bbnew Re n.A. Schetlele, R mwe III— M rRHAnn )
City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract
or agr6e t 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
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P. O. Box 580 AUTHORMED REPRESENTATIVE / ///'//^1///
Fort Collins, CO 80524 [ /,&
USA
rF 1aRR-9n1n ArAPn PnRISnRATInN A11 rinhlx reserve
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
ryan23
39097422
es.w.Itn,cl!
a CERTIFICATE OF LIABILITY INSURANCE D03171IDOIYYYp
ACORO 03/3/2010
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
INA, Inc. - Colorado Division
1705 17th Street
Suits 100
Denver, CO 00202
INSURED
Hydro Construction Company, Inc.
301 East Lincoln Avenue
Port Collins, CO 80524
PHONE
FAX
HUC, No, E.H:
(Alt, No):
EMAIL
ADDRESS:
denDamOimacorD.com
INSURERIS) AFFORDING COVERAGE
NAICF
INSURER A.
PHOENIX INS CO (TlaVeleI'S)
25623
INSURER B:
TRAVELERS PROP CAS CO OF AVER
25670
INSURER Cr
PINRACOL ASSUR
61190
INSURER D
INSURER E
rnwnmaeCQ rFRTIFICATF NIIMRFR• 39096720 REVISION NUMBER:
[HIS 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 AODENVOSeen POLPOLICY NUMBER MMIDIDYyyy POLICY EXP LIMITS
TRSR
A GENERAL LIABILITY DTC06E251268PHX16 04/01/14 04/01/15 EACH OCCURRENCE
S 1,000,000
X DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY PREMISESiEammumema)
S300,000
CLAIMSJMDE X OCCUR NED EXP (My me pe Irm)
$ 10,000
X PD Dsd:$5,000 PERSONAL a ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$2,000,000
GENE AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOPAGG
$2, 000, 000
POLICY X PRO LOC
$
B A� CITY DTB100E216873TIL16 s COMBINED SINGLE LIMB
(Ea acoriem)
S 1,000,000
X ANY AUTO BODILY INJURY (Per Person)
$
ALL OWNED 'SCHEDULED BODILY INJURY(Per wrXwH
$
AUTOS
X X NON OWNED PROPERTY
S
�AUTOS
IDAMAGE
HIRED AUTOS AUTOS (Per
S
B X ,UMBRELLA LW X OCCUR DSHCUP4E216873TIL10 Oe/01/10 04/01/15 EACH OCCURRENCE
S 11000,000
EXCESS UJUS I CLAIMS -MADE AGGREGATE
i 1,000,000
DED X RE TENTION S 10, 000
$
EH-
C WORNERSCOMPENSATMN 2091550 04/01/14 04/02/15 X TOORRYLAPAT 5 ER
AND EMPLOYERS' IJASAITY YIN
ANY PROPRIETORIPARTNEWEXECUTIVE E L. EACH ACCIDENT
$ 1,000.000
OFFICERIMEMBER EXCLUDED' NIA
(Nandamry M NHI EL DISEASE - EA EMPLOYEE
i 1,000,000
It yea, M.Im mme,
DESCRIPTION OF OPERATIONS Wiew E.L. DISEASE POLICY UNIT
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATWNS I VEHICLES (ANaph ACORD 101, Addlennal Remw** Schedule, it mma apace le n9ulmd)
City of Fort Collins is included as Additional Insured on the General Liability Policy it required by written contract
or agreement and with respect to work performed by Insured subject to the policy terms and conditions.
RE: Emergency Generator Installation.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580 AUTHORIZED REPRESENTATIVE //^ ,///
Fort Collins, CO 80522-0000 l/,�//
USA '�A'�
( 1nRA.7ntn ACnRn CTTRPORATff)N All rinHfs reSArvad-
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
cy,.23
39096720