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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (125)AC40R" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 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 A/C No Ext : A/C No E-MAIL DStewart@floodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Phoenix Insurance Company 25623 Greeley CO 80632 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 : INSURER F : Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER: GL/AU/XS/WC 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 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 ADOL15UBK INSD WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE © OCCUR DAMAGE TO RENTE7_ PREMISES Ea occurrence S 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 A Y DT-CO-8G990899-PHX-19 04/01/2019 04/01/2020 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ® PET ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY SINGLE LIMIT COMBINED !Ea cc aident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS Y 810-91-108491-19-26-G 04/01/2019 04/01/2020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H $ UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 10.000,000 AGGREGATE $ 10,000,000 C EXCESS LIAR CLAIMS -MADE Y CUP-2J4008OA-19-26 04/01/2019 04/01/2020 DED I RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY r f N ANY PROPRIETORlPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? El (Mandatory In NH) NIA 2091550 04/0V2019 04/01/2020 PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Project #: 18-01-512 Owner' Project # H-WRF-2018-09 DWRF Digester Circulation Pumps Replacement City of Fort Collins is included as Additional Insured on the General, Automobile, and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CFRTIFICATF 1401 nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street AUTHORIZED REPRESENTATIVE Fort Collins CO 80521 �c�wtll @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD