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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (18)ACORD® CERTIFICATE OF LIABILITY INSURANCE UATE(MM OD YYYY) 1 /3/2015 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 endorsements . PRODUCER Michael J Hall & Company &Company 19660 1 Oth Ave NE NAME: PHONE FAX AC No: 360-598-3703 IAVHall EMAIL ADDREss: ifi INSURERS AFFORDING COVERAGE NAIC 0 Poulsbo WA 98370 INSURER A:Unde ,titers at UoYd's. London INSURED 732 INSURER B : INSURER C: Icon Engineering Inc 8100 South Akron Street, #300 Centennial CO 80112 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 839768832 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. INSR LTR rypE OF ADDL INSIR UBR Wo POLICY NUMBER POLICY EFF MM/DD/YYVY POLICY EXP MM/DDITYry LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMA T ENT D PREMISES Es ocanenca $ CLAIMS -MADE 171 OCCUR MED EXP(Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GENIE AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC JFCT $ OMOBILE LIABILITY Ea eccldeM BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS F BODILY INJURY (Per accident) $ NOWO HIRED AUTOS AUT SEED PP 0�Z t AMAGE $ S UMBRELLA DAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAS CLAIMS -MADE DIED RETENTION$ $ WORKERS COMPENSATION VJC STATU- OTH. AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If YY describe ur,cer DE SCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ A Professional Liab: Claims Made 1104900297/015 1/30/2015 /30/2016 $1,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, AddKlonal Remarks Schedule, If more space Is required) Project: Canal Importation H & H Peer Review 14-024-CIB-415 City of Fort Collins Attn to: Shane Boyle 700 Wood Street Fort Collins CO 80525 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 THE ©1988.2010 ACORD CORPORATION. All rahts reserved ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/3/2015 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 endorsements . PRODUCER NAME: CT Michael J Halt & Company AX PHONE Fac No - NeIL Michael J Hall & Company Hall & Company 19660 10th Ave NE EMA ADDRESS: Poulsbo WA 98370 INSURER 5 AFFORDING COVERAGE NAIC a INSURER A:Unde riters at Lloyd's. London INSURED 732 INSURER B : INSURERC: loon Engineering Inc 8100 South Akron Street, #300 Centennial CO 80112 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 295138560 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. INSR LTR rypE OF INSURANCE ADDL INSR UBR I WO POLICY NUMBER POLICY EFF 1MMMDrYI`YYI POLICY UP MM/DD/YYYY UNITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITYAMA DAMAGERENTED PREMISESERENTE once $ CLAIMS -MADE 171 OCCUR MEDEXP(Anyaneperson) S PERSONAL S ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOG $ AUTOMOBILE LIABILITY Es occident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per amitlenl $ HIRED AUTOS NON -OWNED AUTOS $ UMBRELLA UAB OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS UAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YINTORY LIMITS E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYE E (Mandatory in NH) If yes, descdte under E.L. DISEASE -POLICYLIMIT $ DESCRIPTION OF OPERATIONS belos, Professional Liab: Claims Made 1104900297/015 /30/2015�1=12016 $1,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is nniulmd) Attn to: Shane Boyle Project/Job Name: Poudre River Damage Assessments 13-026-PRD-415 City Of Fort Collins 700 Wood Street Fort Collins CO 80521-1945 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 i. 1988-2010 ACORD CORPORATION_ All riahtn renamarl ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Ac6mbp CERTIFICATE OF LIABILITY INSURANCE MDD YYYY) 1/3/201/2015 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 endorsements . PRODUCER Michael J Hall & Company Hall & Company 19660 1 Oth Ave NE NAME: CT Michael J Hall A r PHONE FA% AD No : - - 3703 E-MAIL ADDREss: h m INSURERS AFFORDING COVERAGE NAIC0 Poulsbo WA 98370 INSURER A: dQDfynjers at Llovd's n INSURED 732 INSURER B : INSURER C: Icon Engineering Inc 8100 South Akron Street, #300 Centennial CO 80112 INSURER D INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 1409054847 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. INSRLTR TYPE OF INSURANCE /N DR ISUSR WVD POLICY NUMBER MMEFF DDY/YYYY1 POLICY UP (MM/DO1Y`fYYI LIMITS GENERALLIABILITY EACH OCCURRENCE If COMMERCIAL GENERAL LIABILITY DAMA ET RENT PREMISES Eao rrence $ CIAIMSd1ADE OCCUR MED UP (Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY Ee aaidern BODILY INJURY (Per person) If ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (PeramJdam) $ PeraERTYDAMAGE $ NON-OHIRED AUTOS AUTOSWNED $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DELI RETENTION $ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERTLIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A TORY LIMITS ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes decR w under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liab: Claims Made 1104900297/015 1/30/2015 /30/2016 $1,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project/Job Name: Box Elder Creek SWMM Conversion - 13-036-BEC-415 City of Fort Collins Attn: Shane Boyle 700 Wood Street Fort Collins CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. yymiREPRESENTATIVEE PR :t ` / `-'/ CORPORATION. All rinhtn rasampri ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD