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109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (16)
P}2Nn2aa; ® DATE iMWODNYYYI A`)IRO CERTIFICATE OF LIABILITY INSURANCE 03/31/2014 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. 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 PRODUCER IM, Inc. - Colorado Division 1705 17th Street Suite 100 Denver, CO 80202 INSURED Hydro Construction Company, Inc. 109420 301 East Lincoln Avenue Fort Collins, CO 80524 PHONE FAX LAIC, No, Ext) LAIC, No): ADDRESS. denpam0lmacorp. COm INSURERB) AFFORDING COVERAGE NAIC9 INSURER A: PHOENIX INS CO (Travelers) 25623 INSURER 8: TRAVRLERS PROP CAS CO OF AMER 25674 INSURER C: PINNACOL ASSUM 41190 INSURER 0. INSURER E. COVERAGES CERTIFICATE NUMMBER: 39096709 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. INSEXP R L1R TYPE OF INSURANCE AOOL S." POLICY NUMBER POLIOIYYYY M.OLIC 'YYY llMRB A GENERAL LIABAItt DTC04825124OPM14 04/01/14 04/01/15 EACHOCCURRENCE $ 1,000,000 X CO_MMERC4 GENERAL LIABILITY NTED PREMISES(EeAGE TO Eamnmlm) S 300,000 CLAIMSMAOE X OCCUR MED EXP IMy Pne Person) $10,000 X RD Ded:$5,000 PERSONAL A ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS � COMPIOP AGG $2,000,000 POLICY X PRDT LOC $ B AUTOMOBILE LIABILITY DTB304E216873TIL14 COMBINED SINGLE LIMIT(Ea 51, 000, 000 X ANY AUTO BODILY INJURY (Per Person) S ALL OWNED SCHEDULED BODILY INJURY roar aamJeM) S AUTOS AUTOS % NON -OWNED NONWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per sccMsnO $ B X UMBRELLA LAS X OCCUR DSMCM49216873TIL14 04/01/14 04/01/15 EACH OCCURRENCE $ 11000,000 EXCESS LAB CLVMS-MADE AGGREGATE $ 1,000,000 DED X RETENTION 10,000 S C WORKERS COMPENSATION 2091550 04/01/14 04/01/15 X WC STATU- O1H- TORY LIMITS ER ANO EMPLOYERSLIABLLItt YIN ANY PROPRIETORNARTNERIEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERMEMBEREXCLUOED? NIA (MFndMmy No NH) EL. DISEASE - EA EMPLOYEE S 1, 000, 000 It 9es, desniLe uMer DESCRIPTION OF OPERATIONS E E L. DISEASE - POLICY LIMIT S 1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Ae4ell ACORD 18L Mditn Ran * SCNMuIF, H mon sare4 b'MRRIoq RE: 7220 water/Wastewater Treatment E Site Infrastructure Design Coastructlon Contractor (6/l/L2 - 5/31/13). city of Fort Collins in included as Additional Insured on the general and Automobile Liability Policies if required by written contract or agreement and with respect to work perfoned by Insured subject to the policy teres and conditions,. rIVMrC r1VLVCr� City of Fort Collins Purchasing Division 700 Wood Street Fort Collins, CO 80521 ACORD 25 (2010105) ryan23 39096709 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. USA //W © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD