HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (113)AC" OF CERTIFICATE OF LIABILITY INSURANCE
F DATE (MMfODIYYYY)
03/25/2019
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 have ADDITIONAL INSURED provisions or 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
CONTACT Dana Stewart, CIC, CISR
NAME:
Flood and Peterson
PHONE (970) 266-7149 FAX (970) 506-6845
AIC No Ezt : AIC No
PO Box 578
E-MAIL DStewart@floodpeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
Greeley CO 80632
INSURER A: Phoenix Insurance Company
25623
INSURED
INSURER B : Charter Oak Fire Insurance Company
25615
Hydro Construction Company Inc.
INSURER C : Travelers Property Casualty Company of America
25674
77 NW Frontage Road
INSURER D : Pinnacol Assurance
41190
INSURER E :
Fort Collins CO 80524
INSURER F :
COVERAGES CERTIFICATE NUMBER: GL/AU/XSNVC x4/2020 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 CONTRACTOR 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
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MM/DD/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ® OCCUR
EACH OCCURRENCE
$ 1,007000
PREMISES Ea occurrence
$ 300.000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
A
DT-CO-8G990899-PHX-19
04/01/2019
04/01/2020
GEN'L AGGREGATE LIMIT APPLIES PER-
POLICY R PRO- ❑
JECT LOC
GENERAL AGGREGATE
$ 21000,000
PRODUCTS-COMPIOPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
810-9L108491-19-26-G
04/01/2019
04/01/2020
BODILY INJURY (Per accident)
5
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
OCCUR
I EACH OCCURRENCE
$ 10,000,000
11
AGGREGATE
$ 10,000,000
C
EXCESS LIAB
CLAIMS -MADE
CUP-2J4008OA-19-26
04/01/2019
04/01/2020
DED I X1 RETENTION $ 10,000
$
WORKERS COMPENSATION
PER OTH-
D
AND EMPLOYERS' LIABILITY Y / N
ANY CERIMEMB PROPRIETOR/PARTNER/EXECUTIVE
OFFICERI REXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
2091550
04/01/2019
04/01/2020
STATUTE ER
E.L.EACHACCIDENT
1,000,000
5
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000
5
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Project #17-01-456, Owners project number SCP-WTF-Chond7-17-17 Reservoir Drainage System
Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named
insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins Utilities
ACCORDANCE WITH THE POLICY PROVISIONS.
700 Wood Street
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80521
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