HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (107)A� oe
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CERTIFICATE OF LIABILITY INSURANCE
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. 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 andorsement(s).
PRODUCER 1-303-536-4567
INA, Inc. - Colorado Division
CONTACT
NAME___
PHONE FA%
WG.N%EMI- AA: No:
ADDRESS: denDamMimaCOrp.C®
A000.E
1705 17th Street
Suite too
Denver, CO 80202
INSURERIS) AFFORDING COVERAGE
NAIL S
INSURERA: PHOBNIE INS CO (Travelers)
25623
INSURED I 'Y��� 1'�
Hydro Construction Company, Inc. I O 4 / V
GGG
INSURER 8: TRAVELERS PROP CAB CO OF ANHR
25676
INSURER C: PINHACOL ASSOR
61190
INSURER D:
301 East Lincoln Avenue
INSURER E:
Port Collins, CO 80526
INSURER F:
COVERAGES CERTIFICATE NUMBER- 41436650 RFVISION NIIMRFR-
. THIS IS -TO CERTIFY: THAT THE. POLICIES OF INSURANCE L!STED,EEI.OW 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.
WSR AODL SUITS POLICY EFF POLICY EXP
Lm TYPE OF INSURANCE POLICY NUMBER MMMD MID° UNITS
A
GEMEMUMV12ITY
DTC04325124OPM14
Od/Ol/1
04/01/15
EACH OCCURRENCE
$1,000,000
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE IXI OCCUR
DAMAGE T RENTED
PREMISES Eao unance
f 300,000
MED EXP one penm
f 10,000
X FD Ded:$5,000
PERSONAL a ADV INJURY
$ 1,000400
GENERAL AGGREGATE
$2,000,000
GERI. AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$2,000,000
POLICY
X PRO- LOC
JFCT
$
B
AUTOMOBILE
LIABILITY
M810dB216873TIL14
1
COMBINED SINGLE LIMIT
En ec mA
1,000,000
BODILY INJURY (Parperson)
,1
X
ANYAUTO
ALL OWNED SCHEOULED
AUTOS AUTOS-0
BODILY INJURY(FW..denl)
i
11
NONWNED
HIREDAUTOS = AUTOS
PROPERTY DAMAGE
mav0enl
1
f
B
E
UYBRE11ALlAe
N
OCCUR
DSNC°P4E216873TIL14
04/01/1
04/01/15
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2,000,000
EXCESS UAB
CLAIMS MADE
DIED I X I RETENTION 10, 000
1
L.
WORRIERS COMPENSATION
ANO EMPLOYERS' LIABILITY YIN
2091550
04/01/1
04/01/15
X WCSTATU- OTM-
E.L. EACH ACCIDENT
$ 1,000,000
ANY PROPRRTORPARTNER,EXECUTIVE❑
OFFICERa1EMBER EXCLUDED? N
NIA
E.L. DISEASE - EA EMPLOYEE
It 1,000,000
(Wndamry In NH)
B DESSCyC deeod0e OF RIPTION OF OPEMTIONS EeMw
E.L. DISEASE -POLICY LIMIT
f 1,000,000
MSCMI NOFOPEMT Sl LOCAMNSIVEHICLES pumr0 AGORD 101. Addttbntl RNnMNe MNeduM,amore epeu HrpuM)
BE: O T3 Sedimentation Basin Improvements Plane 1 - Equipment Pre-purcbasel Hydro-Nnrl? T3 Bquipment-2014-1.
City of Port Collins are included as Additional Insureds on the General Liability Policy if required by written contrac
or agreement and with respect to wrk performed by Insured subject to the policy terms and conditions.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Wood Street AUTHORIZED REPRESENTATIVE /n`%///
Colline , CO 80526 //"& I USA
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
smsando
41436650