HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (34)ACOR[7® CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYQ
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 THECOVERAGE 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 certifioatef older'isan ADDITIONALINSURED,-the poiicy(ies)-must have ADDITIONAL INSURED provisions o► be endoised.
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).
PaooucER
Dana Stewsrt,:CIC, CISR - -
NAME:. ..._ _ -
Flood and Peterson_."
PHONE (970).266-7149 -- .. FAXA/C No:."(970)5W-6845:
ADDliess:. DStewart®600dpetemon.com .. -
PO Box 578
INSUREfl S AFFORDING COVERAGE. - -
NAIC a. -
Greeley CO 80632
INSUReRA: Phoenix Insurance Company
25623
INSURED
INSURER B :. Charter Oak Fire Insurance Company
25615'
INSURER .0 :: -Travelers.Property Casualty Company of America
25674
Hydro Construction Company Inc.
77 NW Frontage Road
INsuRER.D:: Pinnacol Assurance _ _ ._ _ _ _ - _----_-
- 41190
INSURER E: -
INSURER F:
Fort Collins- CO 80524
COVERAGES CERTIFICATE NUMBER: GL/AUIWC/XS x4/21 REVISION NUMBER -
THIS IS TO CERTIFY THATTHE 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. _
IXP
�Tq
TYPE OFINS71LrrY
INSD
D
POLICY NUMBER
MMIDO/Y FF
PMIDD OLICY E
LIMITS,
COMMERCIAL GENE
EACH OCCURRENCE
$ 1,000,000
CLAIM -MADE
PREMISES Eao6mmance
$ 300,000
MED EXP An .one arson _
$, 1Q000
--
PERSONAL&ADVINJURY .
$_1;000,000GEN'LAGGREGATE
A
DT-CO-BG990899-PHX-20
04/01/2020
04/01/2021
LIMIT
GENERALAGGREGATE
$ 2,000,000
POUCV JEC LOC
PRODUCTS--COMP/OP AGG
$ 2,000,000
'
$
OTHER:
AUTOMOBILE
LIABILITY
- -
-
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per parson)—
$
ANV AUTO
B
OWNED SCHEDULED
810-9L108491.20-26-G
04/01/2020
04/01/2021
-
BODILY INJURY (Per accident
$
AUTOS ONLY AUTOS
PROPERTYDAMAGE-
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
8 10,000,000
AGGREGATE
$ 10,000,000
C
I ExCESSUAB
CLAIMS -MADE.
CUP-2J4008OA-20-26
04/01/2020
04/01/20.21
DIED
I X RETENTION $ 10,000
$
WORKERS COMPENSATION
X PER OTH-
ANDEMPLOYERS'LIABILITY YIN
STATUTE ER
E.LEACH ACCIDENT
$ 1,000,000
D
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
2091550
04/Ot/2020
04/01/2021
E.L.DISEASE- EA EMPLOYEE
$It 1,000,000
OFFICER/MEMBEREXCLUDED7
(Mandatory in NH)
describe &ider
1,000,000_
DES, OF -OPERATIONS halaw._. __ _.
DESCRIPTION
_ __
._ __
__.__— _._ __ __.
._-____. _
__ _ __ _.. _
E.LDISEASE-POLICY.UMIT
$
DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES (ACORD 1a1, Atlditional Remerke Schedule, maybe elfeclwtl If more specs is raquiretl)
Re: 18-01-482 DWRF, Strain Press Procurement
H-WRF- 2017-22
Certificate holder is includedasAdditional Insured as required by written contract with respects to liability arising out of work performed by the named
insured.
SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BE CANCELLED BEFORE
THE: EXPIRATION. DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE. WITH THE POLICY PROVISIONS.
300 Laporte Ave
AUTHORIZED REPRESENTATIVE
Fort.Coliins CO 60522 I1 YJQ�
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD