HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (30)A� & CERTIFICATE OF LIABILITY INSURANCE
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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 THEPOLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT:0 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 corder rights to the certificate holder in lieu of such endorsemerd(s).
PRODUCER
Flood and Peterson
PO BOX 578
Greeley CO 80632
CONTACT NAME: Dana Stewart, CIC, CISR
PHONE (970) 266-7149 Arc (970) 506-6845
ADDRESS: DStewart®floodpeterson.com
INSURER AFFORDING COVERAGE
NAIC t.
INSURER A: Phoenix Insurance Company
25623 _
INSURED
Hydro Constriction Company Inc.
77 NW Frontage Road
Fort Collins CO 80524
.INSURER a : _ Charter Oak FireIfl_SUfan00 Company - -
25615
INSURER C: Travelers Property Casualty Company of America
25674
INSURER D : Pinnacol Assurance
41190
INSURER E
INSURER F:
COVFRAGFS CERTIFICATE NUMBER: GUAU/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 FiEOUIREMENT, 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.
LTR .
TYPE OF INSURANCE
I
POLICY NUMBER
M1 D
PM D P
LIMITS
x
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000.000
CLAIMS -MADE ® OCCUR
PREMISES Eaccc rren
a 300,000
MEDEXP one arson
$ 10,000 _
I
A
DT-CO-8G990899-PHX-20
04/01/20120
04/01/2021
.PERSONAL &ADVINJURY
.$ 1.000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
$ 2,000,000
POLICY [9 jECT ElLOC
PRODUCTS-.COMP/OP AGO
-$ 2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident)
$ 1,000,000
BODILY INJURY (Per Person)
$
ANY AUTO
g
OWNED SCHEDULED
AUTOS ONLY AUTOS,
810-9L108491-20.26-G
-
04/01/2020
-
04/01/2021
BODILY INJURV(Peraccident)
$
PROPERTY DAMAGE
Pet acddent)
$
HIRED NON -OWNED
HIRED
AUTOS ONLY - AUTOS ONLY
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$ 10,000,000
C
EXCESS LIAB
CLAIMS -MADE
CUP-2J40080A-20-26
04/01/2020
04/01/2021
AGGREGATE
$ 10,000,000
DED RETENTION $ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' L'ABILITY YINSTATUTE.
ANY PROPRIETORIPARTNERIEXECUTNE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA
2091550
04/01/2020
04/01/2021
PER OTH-
ER
-
E.LEACHACCIDENT
$ 1-,000,000
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
Ityes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 101, Additional Remarba Schedule, may be amahed If more apace 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.
City of Fort Collins
PO BOX 580
Fort Collins
CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
i
915 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD