HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (22)AGOR Is
L� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDYYYYY)
03/20/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE: CERTIFICATE HOLDER. THIS
CERTIFICATEDOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THECOVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTiTI E A CONTRACT BETWEEN THE ISSUING INSURER(SJ AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: N the certificate holder is an ADDITIONAL INSURED, the policy(iss) must have ADDITIONAL INSURED provisions or be endorsed.
N 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 NAME: Dana Stewart, CIC, CISR
Flood and Peterson
PHONE (970);268-7149 F^X. (970) 506-6i845
ADDRESS: DStewart®floodpeterson.com
PO Box 578
INSURER AFFORDING COVERAGE
hkic e
INSURERA: PhoenixlnsuranceCompany
25623
Greeley CO 80632
INSURED
INsuRER.B:. Charter Oak Fire Insurance Company - -
_ _ .- -- -
- 25615
_.__ '--
INSURER c :._Travelers Property Casualty Company of America
25674
Hydro Construction Company Inc.
77 NW Frontage Road
INSURER D: Plnnacol Assurance
41190
INSURER E:
INSURER F :
Fort Collins CO 80524
COVERAGES CERTIFICATE NUMBER: GL/AU/WG/XS x4/21 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.
TYPE OF INSURANCE
POUCYNUMBER
MMIDOIY
MID P
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE-
$ 1,000,000
CLAIMS -MADE ® OCCUR
PREMISES Eaocanrence
$ 300,000
MED EXP An ona am �-
$. _10,900
rA
-
PERSONAL&ADV.INJUflY. _..5.
1,000,000
DT-CO-8G990899-PHX-20
04/01/2020
04/01/2021
.GEN'LAGGREGATEUMrrAPPUES.PER: .
GENERAL AGGREGATE
$ 2,000,000
POLICY 19 PRE T LOC
PRODUCTS -COMP/OPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea acddent
$ 1000,000
BODILY INJURY (Per parson)
$
ANY AUTO
B
OWNED SAUTCHEDULED
AUTOS ONLY OS
F -
810.9L108491-20.26-G
04/01/2020
04/01/2021
-
BODILY INJURY (Per acddanp
—
$
- - - -- -
-
PROPERTY DAMAGE
Peraccidem
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA UAB
OCCUR
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
C
EXCESS UAB
CLAIMS -MADE
CUP-2J40080A-20-26
04/101/2020
04/01/2021
DIED RETENTION $ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' UABIUTY YIN
ANVPROPRIMBR/PARTNER/EXECUTIVE ED
(MandaOFFICEtory In NH) EXCLUDED?
(Mandatory In NH)
N/A
2091550
04/01/2020
04/01/202,
PER
)< STATUTE
E.L. EACH ACCIDENT
$. 1,000,000
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
If
IPTIONescribe under
DESCes,RIPTION
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarke Schedule, may be site ehed if more space ie required)
Re: DWRF- Grit Chamber Rehabilitation
Project 17-01469
H-WRF-2017-17
Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performedby the named
insured.
City of Fort Collins
PO Box 580
Fort Collins
CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THEEXPIRATION DATE YIN Ii DF, NOTICE WILL. BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD