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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (142)A`COROF CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYVYY) 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 Ext : AIC No PO Box 578 E-MAIL DStewart@floodpeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA: 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 0 : Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80524 INSURER F : 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. I LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDY EFF MM DOPOLICY EXP /YYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ®OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A Y DT-CO-8G990899-PHX-19 04/01/2019 04/01/2020 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ©PRO- ❑ PET LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 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) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB 1X101CUR — EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 C EXCESSLIIAB CLAIMS -MADE Y CUP-2J40080A-19-26 04/01/2019 04/01/2020 DED I X RETENTION S 10,000 S D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? � (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 2091550 04/01/2019 04/01/2020 �v/ PER OTH- ^ STATUTE ER E.L. EACH ACCIDENT 1,000,000 S E.L. DISEASE - FA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: 18-01-522 Project #: WTFHydroSS050218 WT Maintenance Services 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. 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 J M��Fort Collins CO 80521 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD