HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (21)ACORV CERTIFICATE OF LIABILITY INSURANCE
(Vi -. -
DATE (MLVDDIYYYY)
03/20/2020
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(iss) must have ADDITIONAL INSURED provisions or be endorsed.
it 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
u02 Dana Stewart, CIC, CISR
Flood and Peterson
IAIC. No PHONE.EXII, (970) 266.7149 A/C No :. FAX (970) 506.8845- --. --
PO Box 578
ADDRESS:- DStewart0800dpeters6n.cor
INSURER AFFORDING COVERAGE
NAICD
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
Cr1VFRAnFS CERTIFICATE NUMBER- Livnu/Inc/Ab xarzi 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�TR
TYPE OF INSURANCE
AUM
j
MUM
POLICY NUMBER
MMIDD/YY
MMIDD/YY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACHOCCURRENCE.
$- 1000000 - _
CLAIMS-MADOCCUR
E ®
PReane EMISES Ea once
$ 300-000
MED EXP one -pion
$ 10,000
A
Y
DT-CO-8G990899-PHX-20.
04/01/2020
04/01/2021
PERSONAL BADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ®Ea LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OPAGG
$ 2,000,000 -
$- -
OTHER:
AUTOMOBILE
LIABILITY
-
--- -- _ -- -
-
- -
COMBINED SINGLE UMIT
Ea accident -
g 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Y
810-9L108491-20-26-G
04/O7/2020
04/01/2021
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Peraccident)
$
It
UMBRELLA LIAR
OCCUR
-_ _ _.
_.
- . - -
.EACH OCCURRENCE
$ 10,0001000
..CLAMS
AGGREGATE -
$ 10,000,000
C
EXCESS LIAS
-MADE.
CUP-2J4008OA-20-26
04/01/2020
04/01/2021
_
MED. RETENTION-$ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS- LIABILITY
ANY PROPRIETOR/PARTNEIVEXECUTIVE ❑Y YIN
OFFICEAIMEMBEREXCLUDED?
(Mandatory in NH)
N/A
2091550
04/01/2020
04/01/2021
PER OTH-
ER
E.L. EACH ACCIDENT
$ 1'�'000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
It Yes. describe under
DESCRIPTION OF OPERATIONS below
- - -.-
..
_. -.E.L.
DISEASE- POUCY.LIMIT
$ 1,000�000
DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD tot, AddlUonal Remarks Sehedub, may be attachedi} mo sebad re epar:a Is required)
RE: 8286 Construction Contractor for Projects at the Water & Wastewater Treatment Facilities.
The City of Fort Collins, its officers, agents and amp loyees are included as Additional Insured,on the.General and Automobile Liability: Policies as required by
written contract or agreement and with respect to work performed by Insured subject to. the policy terms and conditions. The Insurance evidenced by this
certificate will not reduce coverage or limits and will not be cancelled; except after thirty (30) days written notice has been received by the City of Fort
Coiling.
.
SHOULD
_ ._- ..OULD ANY OF . .. THE ABOVE DESCRIBED POLICIESBE CAN_C. EIII ED.BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THEPOUCY PROVISIONS..
PO BOX 580
Fort Collins CO 86522
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ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD