HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (106)M.12W12
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A� v CERTIFICATE OF LIABILITY INSURANCE °08/2 /2 4
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 certHlcate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
PRODUCER
INA, Inc. - Colorado Division
1705 17th Street
Suite 100
Denver, CO 80202
INSURED -
Hydro Construction Company, Inc.
301 Bast Lincoln Avenue
Fort Collins, CO 80524
PHOENIX INSURERS: TRAVBLBRS PROP CAS COlOF ANBR _—— -- INauRFRe- PINNACOL ASSUR I61190
COVERAGES CERTIFICATE NUMBER 41291129 RFVISION NIIMRFR-
THIS IS 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TIE 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.
I TYPE OF INSURANCE ADIR. SUER YYY POUCYEFF I YMNDY EXi
LTR POLICY NUMBER nljc LAWS
A
GENERAL LIABam
DTC04E251248PBX14
04/01/1
04/01/15
EACH OCCURRENCE
$ 1,000,000
x COMMERCNLGENERAL_LIABILITY
DAMAGE TO RENTED
PREMISES(Eaocwnencel__$3
300, 000
x l
$ 10,000
_ CWMS-tMDE I OCCUR
MED EXP(My wePeuan)
x PD Ded:$5,000
PERSONAL a ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2.000,000
LIMIT APPLIES PER:
GENL AGGREGATEROD
PUCTS - COMP20P AGG_(s2,000,000
s 2, 000, 000
IPOLICY I G_
EP F-I
I LOC
I >
B
AMOMOSAE
LJA M
W8104E216873TIL14
COMBINED SINGLELIMIT
(Ea agfaeml_- _
_ 1, 000, 000
$__
$
x
ANY AUTO
BODILY INJURY(Per Pwadn)
ALL OWNED SCHEDULED
AUTOS _ AUTOS
BODILY INJURY Pe, acadenl
( I
3
x
x NON-0WNED
_
PROPERTY DAMAGE
__
—
HIRED AUTOS — AUTOS
(Per arrienml
f
$
B
x
UMBRELLA LAB x OCCUR
DSSICITME218873TIL14
04/01/11
04/01/15
EACHOCCURRENCE
f 2, 000, 000
EXCESSLAB CWMS-MADE
s2, 000, 000
MD x I RETENTION 10,000
_AGGREGATE
Is
D
WORK ERSCOMPENSATION
2091550
04/01/1
04/01/15
WC STATU- I OTH-
x
AND EMPLOYERS' LABILITY YIN
—. TORY.LIMIT$
ANY PROPRIETORIPARTNER)EXECUTNE
OFFICERIMEMSER EXCLUDED? [Nj]
NIA
EL EACH ACCIDENT
L1, 000, 000
-
E L. DISEASE - EA EMPLOYEE
-- -
1, 000, 000
isylaensds" in NH)
DESGRIP�TO OF OPERATIONS Eebw
E.L.DISEASE - POLICY LIMIT I$
_$ _
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (UIach ACORD 101. Addlidwed Rsmwks Schedule, It mere span is rF9ulrW)
City of Fort Collins is included as Additional Insured on the General and Automobile Policies if required by written
contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions.
Upper Butte Stockwell and Soler Pump H-WRF-2014-11.
of Port Collins
Wood Street
Port Collins, CO 80524
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.
n
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
njonee2014
41291129
All A.hs......v.A