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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (34)ICONE-1 OP ID: DIG CERTIFICATE OF LIABILITY INSURANCE FDATE 02/1 /201/2IY016 6 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 Cher Creek Ins. Agency, Inc. CherryPHONE Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTACT NAME: Beth FlCken FAX AIC No Ext : 303-799-0110 A/C No): 303-799-0156 ADDRESS: BethF thinkcci .com Cherry Creek Insurance Group INSURERS AFFORDING COVERAGE NAIC # INSURER A:The Hartford Insurance Group 22357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B : Plnnacol Assurance 41190 Centennial, CO 80112 INSURER C INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: RFVISInN NI IMRFR- 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 I TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F —V� OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE T6�EA PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER A AUTOMOBILE LIABILITY ANY AUTO 134UECTZ5511 01/30/2016 01/30/2017 CEOMaBINdEeDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident)$ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N/A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E,L.EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Box Elder Creek SWMM Conversion - 13-036-BEC-415 '— — l.H1V l.CLLH I ILJIV City of Fort Collins Attn: Shane Boyle 700 Wood Street Fort Collins, CO 80521 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 V 19738-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD No Text ICONE-1 OP ID: DG ,a►�'Ro CERTIFICATE OF LIABILITY INSURANCE FD 02 01/20YYYY) 02/01/2016 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 Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTANAME: Beth Ficken PHONE 303-799-0110 FAX A/c No Ext : Arc No : 303-799-0156 EMAIL s: BethF thinkcci .Com Cherry Creek Insurance Group INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B : Plnnacol Assurance 41190 Centennial, CO 80112 INSURER C INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL R POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO- ❑ JECT LOC OTHER GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 34UECTZ5511 01/30/2016 01/30/2017 CEOMaBIINdEeDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 4077567 02/01/2016 02/0112017 I PER OTH- STATUTE ER E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Project: West Vine Basin Hydrology Update 15-021-WVB-415 City of Fort Collins Attn: Beck Anderson 700 Wood Street Fort Collins, CO 80521 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 V 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG ' Ill- CERTIFICATE OF LIABILITY INSURANCE `--� FDATE 02/011201 YY) 02/01/2016 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 Cherry Creek Ins. Agency, Inc. CONTANAME: Beth Ficken HONE A-799-0110 I-799-0156Suite500 CNo Ed): 303 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 E-MAIL ADDRESS: Beth F@thinkccig.com Cherry Creek Insurance Group INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B : Plnnacol Assurance 41190 7000 S Yosemite St #120 Centennial, CO 80112 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEFx] OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY 7 PRO- ❑ JECT LOC OTHER GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 34UECTZ5511 01/30/2016 01/30/2017 CEOMaBIINdEeDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Michaud Basin Hydrology Update 15-022-MCB-415 u"r I FV I%o i U nvL.vF-rc UANUtLLA I IUN City of Fort Collins Attn: Beck Anderson 700 Wood Street Fort Collins, CO 80521 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG , 6co CERTIFICATE OF LIABILITY INSURANCE `--�'� FDATE 02/01/20YYYY) 02/01 /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 endorsements). PRODUCER Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTANAME, Beth Ficken PHONE FAX A/c No Exc : 303-799-0110 A/C No): 303-799-0156 E_MAI' s: BethF thinkCCi .Com Cherry Creek Insurance Group INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B : Plnnacol Assurance 41190 7000 S Yosemite St #120 Centennial, CO 80112 INSURER C : INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION Nl1MRFR- 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 ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR �34SBAPD8771 01/30/2016 01130/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTEU- PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO- ❑ JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO 34UECTZ5511 01/30/2016 01/30/2017 Ea aBINEDISINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/3012016 01/30/2017 DED X I RETENTION$ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? El N/A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under (Mandatory in and E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Project - Poudre River Damage Assessments 13-026-PRD-415 City of Fort Collins Attn: Shane Boyle 700 Wood Street Fort Collins, CO 80525 L-MI IVIV 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 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG A� Ro CERTIFICATE OF LIABILITY INSURANCE FD 02/01/2 YYYY) 02l01 /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 Cherry Creek Ins. Agency, Inc. Suit 5enc g y 00 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTACT NAME: Beth FlCken AICONNo, Ell: 303-799-0110 A/c No): 303-799-0156 E-MAIL ess: BethF thinkcci .com INSURER(S) AFFORDING COVERAGE NAIC # Cherry Creek Insurance Group INSURER A: The Hartford Insurance Group 122357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B : Plnnacol Assurance 41190 Centennial, CO 80112 INSURER C : INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVICInN NI IMBER• 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rx]OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT F7 LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO 34UECTZ5511 01/30/2016 01/30/2017 Ea E31NEDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ N / A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Canal Importation H & H Peer Review 14-024-CIB-415 City of Fort Collins Attn: Shane Boyle 700 Wood Street Fort Collins, CO 80525 . M,. 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 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG 144c" Ro CERTIFICATE OF LIABILITY INSURANCE DATE 02/01/20YYYY) 2/01/2016 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 Cher Creek Ins. A enc ,Inc. Suit 500 g y 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTACT NAME: Beth Ficken A/CNNo Ext:303-799-0110 n/c No; 303-799-0156 ADDRESS: BethF thinkcci .com Cherry Creek Insurance Group INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B : Plnnacol Assurance 41190 Centennial, CO 80112 INSURER C : INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rx] OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY ❑ PRO- ❑ JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER A AUTOMOBILE LIABILITY ANY AUTO 34UECTZ5511 01/30/2016 01/30/2017 EO aBINdEeDiSINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DIED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA E L YEEI 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Stanton Creek Stabilization 14-042-SCS-352 City of Fort Collins Attn: Mark Kempton 700 Wood Street Fort Collins, CO 80521 _M11 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 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG 14`41co,Rn CERTIFICATE OF LIABILITY INSURANCE FD02/01/2TE YYYY) 2/01 /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 Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Cherry Creek Insurance Group CONTACT NAME: Beth Flcken PHONE 303-0110 FAX 799- A/C No Ext: A/C No): 303-799-0156 ADDRESS, BethF thinkcci .COm INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B : Plnnacol Assurance 41190 Centennial, CO 80112 INSURER C : INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVI-SION 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 LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE )(1 OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTE 0- PREMISES Ea occurrence $ 300,000 VIED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY ❑ PRO- ❑ JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER. A AUTOMOBILE LIABILITY ANY AUTO 34UECTZ5511 01/30/2016 01/30/2017 COEa BINEDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DIED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ N / A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: McClelland's Creek Stream Restoration 14-043—MCR-352 City of Fort Collins Attn: Mark Kempton 700 Wood Street Fort Collins, CO 80521 IIi1-JP1 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 ACORD 25 (2014/01) v lUtlitf-ZU14 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG '441c"R" CERTIFICATE OF LIABILITY INSURANCE FD 02/01/2 YYYY) 02/01 /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 Cherry Creek Ins. Agency, Inc. g y 00 Suit 5encHO 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Cherry Creek Insurance Group CONTACT NAME: Beth Ficken PA,C No xt E: 303-799-0110 FAC No : 303-799-0156 ADDRESS: BethF thinkcci .com INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B : Pinnacol Assurance 41190 Centennial, CO 80112 INSURERC: INSURER D : INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REWSInN NI IMRFR• 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 ADDL UBRPOLICY WVD POLICY NUMBER EFF MM/DD YYYY POLICY EXP YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE FilOCCUR 34SBAPD8771 01/30/2016 01/30/2017 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY ❑PRO- ❑ JECT LOC PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER AUTOMOBILE LIABILITY EOMaBIINdEeDtSINGLE LIMIT $ 1,000,000 A X ANY AUTO 34UECTZ5511 01/30/2016 01/30/2017 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DED X I RETENTION $ 10000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y/N STATUTE I I ER B ANY PROP R IETOR/PARTN E R/EXEC UTIVE OFFICER/MEMBER EXCLUDED? ❑ N /A 4077567 02/01/2016 02/01/2017 E.L. EACH ACCIDENT $ 1,000 ,OOO E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH)and If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Project: First Street Outfall 15-008-FSO-352 A- I - . I, City of Fort Collins Attn: Beck Anderson 700 Wood Street Fort Collins, CO 80521 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 ACORD 25 (2014/01) v 1yi519-zu14 AGOKU CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG '` k-. R CERTIFICATE OF LIABILITY INSURANCE �� -DATE 02101/20YYYY) 02/01 /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 Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTACT NAMEBeth Ficken PHONE FAX A/c No Ex303-799-0110 t : AC,No): 303-799-0156 AII AD REss: BethF@thinkccig.com Cherry Creek Insurance Group INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B : Pinnacol Assurance 41190 7000 S Yosemite St #120 Centennial, CO 80112 INSURER C : INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 A A PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, POLICY PRO- JECT LOC OTHER GENERAL AGGREGATE $ 4,000,000 PRODUCTS -COMP/OP AGG $ 4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 34UECTZ5511 01/30/2016 01/30/2017 CEOMaBINdEeDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4077567 02/01/2016 02/01/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Project: Box Elder Creek CLOMR Review 15-011-BEC-415 City of Fort Collins Attn: Beck Anderson 700 Wood Street Fort Collins, CO 80521 i-PA I I V IY 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 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG '44c"Rf> CERTIFICATE OF LIABILITY INSURANCE TE FD 02/01120YYYY) 02/01 /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 Cherry Creek Ins. Agency, Inc. Suite 500 CONTANAME: Beth Ficken PHONE FAX A/C No Ext : 303-799-0110 A/c No): 303-799-0156 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 E-MAIL ADDRESS: BethF@thinkccig.com Cherry Creek Insurance Group INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B : Plnnacol Assurance 41190 7000 S Yosemite St #120 Centennial, CO 80112 INSURER C : INSURER D : INSURER E : INSURER. F : COVERAGES CERTIFICATE NUMBER: 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 LTR I TYPE OF INSURANCE A L U R POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTE9__ PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER A AUTOMOBILE LIABILITY ANY AUTO X 34UECTZ5511 01/30/2016 01/30/2017 COMEa aBINEDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCU EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMSR -MADE 34SBAPD8771 01/30/2016 01/30/2017 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A 4077567 02/01/2016 02/01/2017LE.L. PER OTH- STATUTE ER EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7300 Consulting Engineering Services for Clearview Channel and Future Minor Capital. As required by written contract or written agreement, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability and Automobile Liability. City of Fort Collins, Purchasing Division Attn: Gerry S Paul P O Box 580 Fort Collins, CO 80522 LANIaLLA I IUN 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DG ,a111ii- CERTIFICATE OF LIABILITY INSURANCE FDATE 02/01/20YYYY) 02/01/2016 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 Cher Creek Ins. Agency, Inc. CherryPHONE Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Cherry Creek Insurance Group CONTACT NAME: Beth Ficken FAX A/C No Ell: 303-799-0110 A/c No): 303-799-0156 a MAIL BethF thinkcci .COm INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:The Hartford Insurance Group 22357 INSURED ICON Engineering Inc 7000 S Yosemite St #120 INSURER B:PInnacol Assurance 41190 Centennial, CO 80112 INSURER C : INSURER D : INSURER E !Nc ,pc COVERAGES CERTIFICATE NUMBER: RFVICInIJ KII IMRFa• 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR 34SBAPD8771 01/30/2016 01/30/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER.I A AUTOMOBILE LIABILITY ANY AUTO 34UECTZ5511 01/30/2016 01/30/2017 (Ea aBINEDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? ❑ NIA 4077567 02/01/2011 02/01/2017 PER OTH- STATUTE ER 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 below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: General Consulting Services. P1044 Consulting Engineering Services W. Orchard Pond and Storm Drainage Project and Future Stormwater Facilities Minor Capital Improvements. City of Fort Collins Purchasing Department 215 N Mason St 2nd Floor Fort Collins, CO 80522 CLi 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 IJ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ICONE-1 OP ID: DIG .4CORJJ �, CERTIFICATE OF LIABILITY INSURANCE E(MM/DD/YYYY) 7OT2/01/2016 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 Cherry Creek Ins. Agency, Inc. 500 5660 Greenwood Plaza Blvd. CONTANAME: Beth Ficken PHONE FA -799-0110 303 -799-0156AC No Ell: 303DSuite E-MAIL ADDRESS: BethF@thinkccig.com Greenwood Village, CO 80111 Cherry Creek Insurance Group INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Hartford Insurance Group 22357 INSURED ICON Engineering Inc INSURER B : Plnnacol Assurance 41190 7000 S Yosemite St #120 Centennial, CO 80112 INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR OF INSURANCE ADDLTYPE INSD SUER POLICY NUMBER MM DD/YYYY MM DD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR X 34SBAPD8771 01/30/2016 01/3012017 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 POLICY PRO ❑ LOC JECT $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO X 34UECTZ5511 01/30/2016 01/30/2017 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2016 01/30/2017 DED TXTF1ETENTION $ 10000 $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 4077567 02/01/2016 02/01/2017 PER OTH- ER STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: 8073 Engineering Services for Future Water, Wastewater & Stormwater Capital Improvements. The City, its officers, agents and employees shall be named as additional insureds on the General Liability and Automobile liability policies for any claims arising out of work performed under this Agreement. The insurance evidenced will not be cancelled, except after L;rK 1 11-IL;A I r- h1ULUrK City of Fort Collins Attn: Ms Pat Johnson CPPB 700 Wood Street Fort Collins, CO 80521 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD