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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (25)P5261)U2alg2 " AC" CERTIFICATE OF LIABILITY INSURANCE °1"2/29/2°0 5"' 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 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 1-303-534-4567 CONTACT _NAME_ INA, Inc. - Colorado Division PHONE FAX JALF.-N4..EXU_--.--_. (A/C. No): E-MAIL denaccounttechsgimaco 1705 17th Street _ADDRESS: Zp. COID Suite 100 INSURERS AFFORDING COVERAGE NAIC • Denver, CO 80202 INSURERA: PHOENIX INS CO (Travelers) 25623 INSURED INSURER B: TRAVELERS IND CO OF AMER 25666 Hydro Construction Company, Inc. INSURERC: TRAVELERS PROP CAB CO OF AMER 25674 301 East Lincoln Avenue INSURERD: PINNACOL ASSUR 41190 INSURER E : Fort Collins, CO 80524 INSURER F: COVFRAGFS CFRTIFICATF NI IMRFR• A57SA11i oevrmnu wwoos. THIS IS TO CERTIFY THAT THE POLICIES, Cr' 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 ADDL SURF______POLICY WVI3POLICY NUMBER EFF MMIDD/YYYY) POLICY EXP (MMIDDrYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR DTCO4E216873PHX15 04/01/15 04/01/16 EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea oxurrence $ 300, 000 X MED EXP (Any one person) $ 10,000 PD Ded: $5, 000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: g PRO - POLICY __ JECT L _] LOC GENERAL AGGREGATE $ 2,000 000 GENT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: 1 B AUTOMOBILE -(Ea LIABILITY DT810492168731ND15 04/01/15 04/01/16 COMBINED SINGLE LIMIT accident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OS AUTOSSCHEDLED AUTOS -. AUTOS BODILY INJURY Per accident ( ) $ X — HIRED AUTOS X NON -OWNED _ AUTOS PROPERTY DAMAGE Per accident $ $ C X UMBRELLA LIAB 8 OCCUR DTSHCUP4E216873TIL15 04/01/15 04/01/16 EACH OCCURRENCE $ 2,000,000 - EXCESS LIAB _ CLAIMS -MADE_ AGGREGATE $ 2,000,000 ME D X RETENTION$ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N / A 2091550 04/01/15 04/01/16 X STATUTE OR El. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA ENIPLOYEd $ 1,000,000 (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Fort Collins is included as Additional Insured on the General, Automobile, and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. —1 -^ LAPII.[LLAI IUN RE: WTF Chlorine Contact Basin Earthwork; Job# SCP-WTFCCB-122815. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1700 Wood Street (Fort Collins, CO 80521 USA AUTHORis:D REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD sadie55 45754113 00 10 rn W Vsl6iei>mnr_ " AC ©® la/07/2 CERTIFICATE OF LIABILITY INSURANCE DATE/7/2o15 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 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 1-303-534-4567 CONTACT NAME: IRA, Inc. - Colorado Division ---- -_"---------- --- PHONE (A/cNo. E tll E-MAIL denaccounttechoQimaco 1705 17th Street ADDRESS: rD•com Suite 100 _ INSURERS) AFFORDING COVERAGE NAIL i Denver, CO 80202 INSURER A: PHOENIX INS CO (Travelers) 25623 INSURED INSURER e : TRAVELERS nW CO OF AMER 25666 Hydro Construction Company, Inc. INSURERC: TBIIVELERB PROP CAS CO OF AMER 25674 301 East Lincoln Avenue INSURERD: PINNACOL ASSUR 41190 INSURER E : Fort Collins, CO 80524 INSURER F: COVERAGES CFRTIFICATF NIIMRFR• 45545313 RFVICIAN N11MriFR- 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 SUER POLICY NUMBER MM/DDPOLICYEFF IYYYY MMLDDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE — OCCUR DTCO4E216873PHX15 04/01/15 04/01/16 EACH OCCURRENCE = 1,000,000 DAMAGE TORENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) : 10, 000 PD Ded: $5, 000 PERSONAL 6 ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC GENERAL AGGREGATE $ 2,000,000 GENT. PRODUCTS -COMPbPAGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY DT8104E2168731ND15 04/01/15 04/01/16 CO(Ea acMBINEDSINGLELIMITcident) $ 1,000,000 BODILY INJURY (Per person) _ $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTYDAMAGE Per accident : $ C X UMBRELLALIAB7F.UR DTSRCUP4E216873TIL15 04/01/15 04/01/16 EACH OCCURRENCE s 2,000,000 AGGREGATE EXCESS LAB IMS-MADE $ 2,000,000 DED X RETENTION $ 10, 000 1$ D WORKERS COMPENSATION AND EMPLOYERS' LABILITY YIN ANY PROPRIETONPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a N/A 2091550 04/01/15 04/01/16 X S ATUT OTH R E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS bekrw I E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) City of Fort Collins is included as Additional insured on the General, Automobile, and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. %,arc i irra.m i c. nvLLOrK GANI;tLLA I IUN [Mil: D7FOrt -SPT Slide Oate Replacement; Job# H-WRF-2015-14.SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street Fort Collins, CO 80524 USA AUTHORED REPRESENTATIVE U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ashmcclain 45545313 W1 1 52M1W2x(AQ A�� DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I11/18/2015 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 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 1-303-534-4567 CONTACT NAME: IMA, Inc. - Colorado Division PHONE FAX (A/C, No. Ex* LAIC, No): 1705 17th Street E-MAIL ADDRESS: denac count t echs@imaC 0I'p'CO>•_ _-_ Suite 100 INSURER(S) AFFORDING COVERAGE _ _ _ _ _._ _.NAIC0 Denver, CO 80202 INSURER A: PHOENIX INS CO (Travelers) 25623 INSURED INSURERS: TRAVELERS IND CO OF AMER 25666 Hydro Construction Company, Inc. INSURERC: TRAVELERS PROP CAS CO OF him 25674 PINNACOL ASSUR 41190 301 East Lincoln Avenue _INSURERD: INSURER E : Fort Collins, CO 80524 INSURER F: C0VFII CERTIFICATE NUMBER- 45468488 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS L WVD A. X COMMERCIAL GENERAL LIABILITY DTCO4E216873PHX15 04/01/15 04/01/16 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE , X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 -. X PD Ded:$5, 000 MED EXP (Anyone person) $ 10,000 PERSONAL 4ADVINJURY $ 1,000.000 S 2, 000, 000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY I X JE T , LOC PRODUCTS COMP/OP AGG $ 2,000,000 OTHER. $ H AUTOMOBILE LIABILITY . _ DT8104E216873IND15 04/01/15 04/01/16 COMBINED SINGLE LIMIT (Ea accident) $ 1 000,000 X ANY AUTO BODILY INJURY (Per person) $ _ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ _ AUTOS _ AUTOS _ - X NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS E AUTOS (Per accident) C X UMBRELLA LIAB X OCCUR DTSMCUP4E216873TIL15 04/01/15 04/01/16 EACH OCCURRENCE $ 2,000,000 EXCESS LU18 CLAIMS -MADE AGGREGATE $ 2,000,000 DED I X RETENTION $ 10, 000 $ ID COMPENSATION 2091550 04/01/15 04/01/16 X STATUTE ERA A UTI AND AND EMPLOYERS' LIABILITY YIN - . --- -.._ ---- ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? � N /A - _- "" -- --- — (Mandatory in NH) E.L. DISEASE - EA EMPLOY $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below - POLICY LIMIT $ 1, 000, 000 i tii2SEASE DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) 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. GtK 1 IrR A I t MULUtK L,AN1L rLLA I IUIN RE: Various maintenance items; Job# WTF Fall 2015 Maintenance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street Fort Collins, CO 80521 USA AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD spmaestas 45468488 P52NI021PX12 R ACORO® DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/24/2016 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 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 1-303-534-4567 CONTACT NAME'.__------ In, Inc. - Colorado Division PHONE �FAx Ed1A1L F.H. Nol: UVC, ADORE 1705 17th Street : denaccounttechsQimacorp.com Suite 100 INSURERS AFFORDING COVERAGE NAK:3 Denver, CO 80202 INSURERA: PHOENIX INS CO (Travelers) 25623 INSURED INSURER a : TRAVSL tS IND CO OF AMBR 25666 Hydro Construction Company, Inc. INSURER CTRAVBLBRS PROP CAS CO OF AMER 25674 301 Bast Lincoln Avenue INSURER0: PINNACOL ASSUR 41190 INSURER E : Fort Collins, CO 80524 INSURERF: CAVFRACFS CFRTIFICATF NtIMRFR• 46127804 REVISION NUMFIFR- 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. Y18R LTR TYPE OF INSURANCE ADDL BR POLICY NUMBER POLICY EFF MPP POLICY EXP LIMITS A Y COMMERCIAL GENERALLWBUTY DTCO4B216873PHX15 04/01/15 04/01/16 EACH OCCURRENCE $ 1,000,000 OCCUR D T a occurrence) DAMAGCLAIMS-MADElxl PREMISES Eaoxurrence PREMISES $ 300,000 z MED EXP (Any one person) $ 10,000 PD Ded: $5, 000 _ PERSONAL dADVINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENT POLICY a JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER. B AUTOMOBILELIABILTTY DT810482168731ND15 04/01/15 04/01/16 COEa ecdd MBINnEDSINGLELIMIT t $ 1,000,000 BODILY INJURY (Per parson) $ z ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE P dent f NON -OWNED X HIRED AUTOS X AUTOS S C z UM I OCCUR DTSMCUP4B216873TIL15 04/01/15 04/01/16 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EM 53 LIAR CLAIMS -MADE DED X RETENTION 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERIEXECUTIVE a OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N I A 2091550 04/01/15 04/01/16 ETH- z STATUTE I E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be aaachad H more space Is required) City of Fort Collins is included as Additional Insured on the General, Automobile, and umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. GEKIII•IGA I t HULULK 66AN"L.L.A I IVN RE: WTF Chlorine Contact Basin Phase 2 - Rebar; JobBSCP-WTFCCB2-022916. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street Fort Collins, CO 80524 USA AUTHORIZED REPRESENTATIVE m 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD spmaestas 46127804 rn 00 00 00 z w