HomeMy WebLinkAboutPEAK ELEVATOR PERFORMANCE GROUP - INSURANCE CERTIFICATE (5)P326002II002
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A� o® CERTIFICATE OF LIABILITY INSURANCE
o4/2s/z014
O04/29IpD/14
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
certificate holder in lieu of such endorsement(s).
PRODUCER 1-303-534-4567
INA, Inc. - COlOIIIdO Division
CONTACT
NAME:PHONE
FAX
.(AIC.No E;dl' (AIC, Nol:
1705 17th Street
Suite 100
EMAIL deOpeJMdimacoxy.cam
ADDRESS:
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Denver, CO 80202 ^ 1
`f�UC(y `f1
INSURERS AFFORDING COVERAGE
NAIC4
INSURERA: PHOENIX INS CO (Travelers)
25623
INSURED `v \
Hydro Construction Company, Inc.
INSURERe: TRAVELERS PROP CAS CO OF AMER
25674
INSURERC: PINNACOL ASSUR
41190
INSURER O:
301 East Lincoln Avenue
INSURER E:
Port Collins, CO 80524
INSURER F:
COVERAGFS CFRTIFICATF NIIMRFR• 39482047 RFVICInM MIIMRFo•
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,
LTR TYPE OF INSURANCE NSHISUBRI POUCYNUMBER Mu's MMNDy-P UNITS
A
GENERAL LIABILITY
D1ICO4H251248PHX14
04/01/14
04/01/15
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TORENTED
PREMISES(Eaoccunence
$ 300,000
CLAIMS -MADE � OCCUR
MED EXP(Any one Person)
$ 10,000
X PD Ded:$5,000
PERSONAL$ ADV INJURY
$ 1,000,000
GENERALAGGREGATE
$ 2,000,000
GENI AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGO
$2.000,000
POLICY
X PRO, LOC
$
9
AUTOMOBILE
LU3ILITY
DT8104E216873TIL14
4/01
COMBINED SINGLE LIMIT
(Es em_ denl
5 1,000,000
X
ANY AUTO
BODILY INJURY(Per penon)
$
ALL OWNED AUTOS LED
SCHED
AUTOS AUTOS
BODILY INJURY Per acdder0
$
X
NON -OWNED
HIRED AUTOS P AUTOS
PROPERTY DAMAGE
(Per emMent
$
_
$
B
X
UMBRELLA UAB
X
OCCUR
DS14CUP4E216873TIL14
04/01/14'
04/01/15
EACHOCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
EXCESS LIAS
CLAIMS -MADE
DED I R I RETENTIONS 10,000
$
C
WORKERS COMPENSATION
2091550
04 /O1/1
04/O1/15
WCSTATU- OTH-
XORYLIMIIS
AND EMPLOYERS' LIABILITY YIN
E.L. EACH ACCIDENT
$ 11000,000
ANY PROPRIETORNARTNERI ECUTIVE
OFFICERa1EMBER EXCLUDED? a
NIA
EA- DISEASE - EA EMPLOYEE
S 1, 000, 000
(Mandatory In NH)
Ur deevibe uMer
E.L. DISEASE -POLICY LIMIT I
S1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTIONOFOPERATONSILOCATIONSIVEHICLES(AMch ACORD101,Addmonal Ramada Scbdula,Rmonapace Iar ubad)
City of Port Collins is included as Additional Insured On the General Liability Policy if required by written contract
or agreement and with respect to wrk performed by Insured subject to the policy terms and conditions.
DWRF - Centrifuge Feed System Replacement -
truction H-4IAF-2014-5.
of Fort Collins
Wood St.
Collins, CO 80522
USA
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 MR
01988.2010 ACORD CORPORATION. All
ACORO 25 (2010/05) The ACORD name and logo are registered marks of ACORD
ke11ym2013
39482047
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