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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (23)ICONE-1 OP ID: DO ,44coR15' CERTIFICATE OF LIABILITY INSURANCE ��- DATE(MM/DDIYYYY) 01/20/2015 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 Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Cherry Creek Insurance Group CONTACT NAME: Cher Creek Insurance Group PHONE FAX WC No Ert:303-79_9-0110 ac Na: 303-799-0156 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B: Plnnacol Assurance 41190 Mr Penn Gildersleev 8100 South Akron Street #300 INSURER C: Englewood, CO 80112 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADD B POLICY NUMBER MM POLICY EFF- /DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 GI-AIMsMAOE occuR X 34SBAPD8771 01I30/2015 01I30I2016 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,00 POLICY PRO- JECT ❑ LOG PRODUCTS - COMP/OPAGG $ 4,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident g 11000,00 BODILY INJURY (Per Person) S A X ANY AUTO X 34UECTZ5511 01/30/2016 01/30/2016 ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accident)$ PROPERTY DAMAGE Per accident $ NON -OWNED HIREDAUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS DAB CLAIMS -MADE DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERMXECUTIVE YIN 4077567 02/01/2015 02/01/2016 X PER OTH- STATUTE ER EL. EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED' (Mandatory In NH) N/A EL. DISEASE - EA EMPLOYEE S 500,00 If yes desaibe under DESCRIPTION OF OPERATIONS bei. E.L. DISEASE -POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is mclulmd) RE: 7300 Consulting Engineering Services for Clearview Channel and Future Minor Capital. As required by written contract or written agreement, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability and Automobile Liability. City of Fort Collins, Purchasing Division Attn: Gerry S Paul P O Box 580 Fort Collins, CO 80522 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 X ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DD '44cCERTIFICATE OF LIABILITY INSURANCE L.� D01120ATE /2016 ) 01/20/2015 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 endorsement(s). PRODUCER Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Cherry Creek Insurance Group NAMEA T Cherry Creek Insurance Group PHONE AX A/c No Ert:303-799-0110 FA/C, No: 303-79MI56 EMAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC9 INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B: Pinnacol Assurance 41190 Mr Penn Gildersleev 8100 South Akron Street#300 NSURER C: Englewood, CO 80112 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE INSD POLICY NUMBER DD/YYYY MML MMIOD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 CLAIMS -MADE FK OCCUR 34SBAPD8771 01/30/2015 01/30/2016 PREMISES Eaocanence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL S ADV INJURY $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,00 PRO-JECT LOC POLICY PRODUCTS - COMP/OP AGO $ 4,000,00 $ OTHER AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT Ea accident $ 1-,000,00 BODILY INJURY (Per person) $ A X ANY AUTO 34UECTZ5511 01/30/2015 01/30/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ I PROPERTY DAMAGE Pare ccitlent $ NOWOWNED HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEO I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER E%CWOED? (Mandatory In NH) NIA 4077567 02/01/2015 02/01/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 600,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 1/yes. describe under DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ 600,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may ha aNeched If mom space Is required) RE: General Consulting Services. P1044 Consulting Engineering Services W. Orchard Pond and Storm Drainage Project and Future StormTrater Facilities Ninor Capital Improvements. City of Fort Collins Purchasing Department 215 N Mason St 2nd Floor Fort Collins, CO 80522 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD