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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (169)AC" OV CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 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 (g70) 266-7149 FAX (970) 506-6845 /C No Ext : A1C No (",C. PO Box 578 E-MAIL DStewart@floodpeterson.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL X 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 D : Pinnacol Assurance 41190 INSURER E : Fort Collins CO 30524 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. INSR LTR TYPE OF INSURANCE ADUL INSD 5UBR WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE © OCCUR PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) S 10,000 PERSONAL& ADV INJURY $ 1,000,000 A DT-CO-8G990899-PHX-19 04/01/2019 04/01/2020 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY ® JJECT LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMPIOP AGG $ 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) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ 21 UMBRELLA LIAB OCCUR EACH OCCURRENCE S 10,000,000 AGGREGATE $ 10,000,000 C I EXCESSLIIAB CLAIMS -MADE CUP-2J4008OA-19-26 04/01/2019 04/01/2020 DED I X RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFIC tort' In H) EXCLUDED? (Mandatory to NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 2091550 - 04/01/2019 04/01/2020 STAT /� LITE ERH E.L. EACH ACCIDENT 1,000,000 S E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 S DESCRIPTION OF OPERATIONS! LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: 18-01-479 DWRF - Dewatering Centrifuge Procurement: Job#H-WRF-2017-18 City of Fort Collins is included as Additional Insured on the General and Automobile Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CERTIFICATE HOLDER 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. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD