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Home My WebLink About109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (27)�1 6b CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 3/30/2016 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 CONTACT Nikki Mosbrucker CIC, CISR Flood and Peterson PHC E E:f: (970)266-7123 FA Nc:(970)506-6823 PO Box 578 AIL ADDRESS:NMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INSURERB:Trayelers Indemnity Compan 25658 Hydro Construction Company Inc. INSURERC:Travelers Property Casual t Com an 25674 301 E Lincoln Ave INSURERD:Pinnacol Assurance 41190 INSURER E: Fort Collins CO 80524 INSURERF: VV varlmuco CEFi I iFiCA I t NUMBER:LL1b328U9881 REVISION NU MBER. 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. RJSR LTR A X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR ADDL X SUBR POLICY NUMBER DTC08G990899PHX16 POLICY EFF MM/DDNYYY 4/1/2016 POLICY EXP MM/DDNYYY 4/1/2017 LIMBS EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300, 000 MED EXP (Any one person) $ 10, 000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I - I JECOT- = LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 B C D I 1 I AUTOMOBILE LIABILITY ANY AUTO AOSCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB X OCCUR EXCESS LIAR CLAIMS -MADE X X N/A DT810SC990899IND16 DTSMCUP8G990899TIL16 4012016 4/1/2016 20 1 4 /16 / 4/1/2016 4/1/2017 4/1/2017 4/1/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ Underinsured motorist EACH OCCURRENCE $ 1,000,000 $ 5,000,000 H AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below X PER OTH- STATUTE ER $ E.L. EACH ACCIDENT $ 1,000,000 000 E.L. DISEASE- EA EMPLOYE $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 2015 General Pipeline Emergency Repair 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 700 Wood Street Fort Collins, CO 80521-1945 r�l�v LLLM I IVIY 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 Mosbrucker CIC,CISR ACORD 25 (2014/01) v 1at18-ZU14 AGUHU CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/30/2016 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 CONTACT Nikki Mosbrucker CIC, CISR Flood and Peterson PHONE (970) 266-7123 PO Box 578 C No Ext: a/c No: (970)506-6823 ADURess:NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC N Greeley CO 80632 INSURERA:Phoenix Insurance Company-25623 INSURED INSURERB:Travelers Indemnity Company 25658 Hydro Construction Company Inc. 301 E Lincoln Ave INSURERC:Travelers Property Casualty Company 25674 INSURERD:Pinnacol Assurance 41190 INSURER E Fort Collins CO 80524 INSURERF: --- ------ -_-.. __. .. ------ nCvlalu N PAUmtStF{: 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. LTR I TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR X DTCOSG990899PHX16 4/1/2016 4/1/2017 EACH OCCURRENCE IS 1,000,000 DAMAGE TO, PREMISES E UNITED $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I - JEo 11 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO AOSCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS X DT81080990899IND16 4/1/2016 4/1/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ Underinsured motorist $ 11000,000 C I D X UMBRELLA LIAR EXCESS LIAB $ OCCUR CLAIMS -MADE X N/A DTSMCUP8G990899TIL16 4012016 20 1 4 /16 / 4/1/2016 4/1/2017 4/1/2017 EACH OCCURRENCE $ 51000,000 AGGREGATE $ DED RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below PER OTH- X LITEATSTER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYE $ 11000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 16-03-391 DWRF - SPT Slide Gate Replacement; Job# H-WRF-2015-14. 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. CGRTI CI!`ATC LIr11 nCo _ _ City of Fort Collins 700 Wood St. Fort Collins, CO 80521-1945 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 N Mosbrucker CIC,CISR " l WOO-ZU 14 AL;UHU UUKPUHATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) �1 A�oRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/30/2016 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 Flood and Peterson PO Box 578 CONTANAME: Nikki Mosbrucker CIC,CISR A% NN Ext: (970)266-7123 FAX No; SS:(970)506-6823 ADDRENMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 _ INSURERA:Phoenix Insurance Com an 25623 INSURED Hydro Construction Company Inc. 301 E Lincoln Ave INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty Company 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80524 INSURERF: 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 YPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Lk OCCUR X DTCOBG990899PEX16 4/1/2016 4/1/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Anyone person) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY C PRO - POLICY LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 B C AUTOMOBILE LIABILITY ANY AUTO ALL OSCHEDULED AUUTOSS AUTOS HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAR X OCCUR EXCESS LIAB CLAIMS MADE X X DT8108G990899IND16 DTSMCUPBG990899TIL16 4/1/2016 4/1/2016 4/1/2017 4/1/2017 Ea aoci E7SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X Underinsured motorist EACH OCCURRENCE $ 1,000,000 $ 5,000,000 AGGREGATE $ DED I I RETENTIONS $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/W ANY PROPRIETOR/PARTNERlEXECUTIVE OFFICER/MEMBEREXCLUDED? NI (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below N/A 4012D16 4/1/2016 4/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE -- $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 16-03-389 DWRF - SPT Final Clarifier Scum Pump Replacement; Job#H-WRF-2015-13. 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 700 Wood Street Fort Collins, CO 80521-1945 1 IVIY 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) INS025 (201401) Mosbrucker CIC,CISR YLSK46"Ziz� k9 196a-2U14 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/30/2016 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 Flood and Peterson PO Box 578 CONTACT NAME: Nikki Mosbrucker CIC, CISR PHONE FAX 1A/1:,N0.EXU; (970)266-7123 (A/C No)- (970)506-6823 E-DRESS:NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC If Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED Hydro Construction Company Inc. 301 E Lincoln Ave INSURERB:Travelers Indemnity Company 25658 INSURERC:Travelers Property Casualty Company 25674 INSURERD:Pinnacol Assurance 41190 INSURER E : _ Fort Collins CO 80524 INSURERF: COVERAGES CFHTIFICATE NUMBER:CL1632809881 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 ADDL IN I SUER POLICY NUMBER MM DDNYYY MM/ D/YYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300, 000 MED EXP (Any one person) $ 10,000 X DTCOBG990899PHX16 4/1/2016 4/1/2017 — PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY -- I PECOT- El LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY ANY AUTO ALL OS SCHEDULED AUTOS AUTOS X DT810BG9908991ND16 4/1/2016 4/1/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) _ $ BODILY INJURY Per accident ( ) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X (-, OCCUR EXCESS LIAB CLAIMS -MADE DTSMCUPBG990899TIL16 4/1/2016 4/1/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ DED I I RETENTION $ $ X D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 40120J_6 4/1/2016 4/1/2017 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 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) RE: 16-01-392 Various maintenance items; Job# WTF Fall 2015 Maintenance 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 700 Wood Street Fort Collins, CO 80521-1945 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) INS025 (201401) Mosbrucker CIC, CISR 1919tis-2U14 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCOROF CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD(YYYY) r il..� 3/30/2016 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 NAME: ACT Nikki Mosbrucker CIC,CISR Flood and Peterson ONED Ext. (970) 266-7123 F� PHNo: (970)506-6823 PO Box 578 AIL ADDRESS:NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC / Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INSURERB:Travelers Indemnity Company 25658 Hydro Construction Company Inc. INSURERC:Travelers Property Casualty Company 25674 301 E Lincoln Ave INSURERD:Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80524 INSURERF: cuversAGES CERTIFICATE NUMBER:CL1632809881 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 SUER POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MM/DDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 11000,000 MA EToRENTED DAMAGE To RENTE PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 X DTC08G990899PHX16 4/1/2016 4/1/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECOT LOC GENERAL AGGREGATE $ 21000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 OTHER: AUTOMOBILE LIABILITY ANY AUTO AU OS SCHEDULEDDT810SG990899IND16 AUTOSAUTOS XHIRED 4/1/2016 4/1/2017 Ea aBINED SINGLE LIMIT (ccidenB $ 11000,000 BODILY INJURY (Per person) $ JX BODILY INJURY (Per accident) $ AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ Underinsured motorist $ 1,000,000 C X UMBRELLA LIAB X OCCUR EXCESS LIAB 1-7 CLAIMS -MADE X DTSMCUP8G990899TIL16 4/1/2016 4/1/2017 EACH OCCURRENCE $ s - 000, 000 AGGREGATE $ DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yyes, describe under DESCRIPTIONOFOPERATIONS below N/A 4012016 4/1/2016 4/1/2017 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYE $ 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) RE: 8106 Utility Infrastructure Const. Services for Water, Wastewater & Storm Water Facilities Capital Improvements. 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. City of Fort Collins 700 Wood Street Fort Collins, CO 80521-1945 1 lull 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) INS025 (201401) MOSbrucker CIC, CISR V 1 yt3r3-Zoi 4 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A�oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/30/2016 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 CONTACT NAME: Nikki Mosbrucker CIC,CISR Flood and Peterson a✓c°NNo t: (970)266-7123 FAX A/C No: (970)506-6823 PO Box 578 AIL ADDRESS:NMosbrucker@floodpeterson.com Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INsuRERB:Travelers Indemnity Company 25658 Hydro Construction Company Inc. INSURERC:Travelers Property Casualty Company 25674 301 E Lincoln Ave INSURERD:Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80524 INSURERF: CnVFRAGFS r'PQTI=Ir`ATC nnI11dCC17.rT.1 rz)Anoaal 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 ADOL SUBR JJ Wyn POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYV -- — -- _— LIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000, 000 A 1�� CLAIMS -MADE d l OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 300, 000 MED EXP (Anyone person) _ $ 10,000 X DTCOSG990899PHXIG 4/1/2016 4/1/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X PRO GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY i LOC Employee Benefits $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALLOWNEDSCHEDULED BODILY INJURY Per accident ( ) $ AUTOS AUTOS X DT810BG990899IND16 4/1/2016 4/1/2017 HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Underinsured motorist $ 1,000,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ C EXCESS LIAB CLAIMS-MADE DTSMCUPBG990899TIL16 4/1/2016 4/1/2017 DED i I RETENTION S $ X WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE I ER E.L. EACH ACCIDENT $ 11000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A D (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 4012016 4/1/2016 4/1/2017 E.L. DISEASE- EA EMPLOYE $ 11000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 16-01-394 WTF Chlorine Contact Basin Earthwork; Job# SCP-WTFCCB-122815. 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.M19t1CLLfi I IUIV City of Fort Collins 700 Wood Street Fort Collins, CO 80521-1945 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 Mosbrucker CIC, CISR U 1aas-ZU14 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 3/30/2016 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 CONTANAME: Ni.kk1 Mosbrucker CIC, CISR Flood and Peterson PHONE - A/C No Ext: (970) 266-7123 FAX No: (970)506-6823 PO Box 578 aDORless:NMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INSURERB:Travelers Indemnity Company 25658 Hydro Construction Company Inc. INSURERC:Travelers Property Casualty Co m an 25674 301 E Lincoln Ave INSURERD:Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80524 INSURERF: -----------------•• - - -- --- nr=vrJIV1Y IYUIVI lSrI'i: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDPOLICY NUMBER MM/DDNYYV) (MM/DDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR X DTCOBG990899YHX16 4/1/2016 4/1/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY -- !I JE � LOC I OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 B C D AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUUTOSS AUTOS HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB X OCCUR EXCESS LIAR CLAIMS -MADE X X N/A DT810BG990899IND16 DTSMCUP8G990899TIL16 4012016 4 1 2016 / / 4/1/2016 4/1/2016 4/1/2017 4/1/2017 4/1/2017 COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X F—� Underinsured motorist EACH OCCURRENCE -- $ 11 000, 000 $ 5, 000, 000 I AGGREGATE -- --- $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) If yes, e DESCdescribe IPTIONscribe under OF OPERATIONS below X I STATUTE ER $ E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE -EA EMPLOYE $ 11000,000 E.L. DISEASE - POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7220 Water/Wastewater Treatment & Site Infrastructure Design/Construction Contractor. City of Fort Collins is included as Additional Insured on the General Liability Policy 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. r�rorronwTr un, r,rr, City of Fort Collins 700 Wood Street Fort Collins, CO 80521-1945 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) INS025 (201401) N Mosbrucker CIC, CISR CZ"`✓� v 1%lt%ts-ZU14 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORff CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 3/30/2016 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 CONTACT Nikki Mosbrucker CIC, CISR Flood and Peterson PO Box 578 PHONE (970) 266-7123 FAX M. xt: A/C No: (970)506-6623 ADDRESS:NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INSURERB:Travelers Indemnity Company 25658 INSURERc:Travelers Property Casualty Company 25674 Hydro Construction Company Inc. 301 E Lincoln Ave INSURERD:Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80524 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1632809881 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 ADDL SUBR WVDPOLICY NUMBER PM DD/YYYY PM/DDNY P LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR EACH OCCURRENCE $ 1,000,000 AMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 X DTC08G990899PEX16 4/1/2016 4/1/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYIIPEA LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED t INGLE LIMIT E $ 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OS SCHEDULED AUTOS AUTOS %� DT8108G9908991ND16 4 1/2016 / 4/1/2017 BODILY INJURY Per accident ( ) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 51000,000 AGGREGATE $ C EXCESS LIAB CLAIMS -MADE DTSMCUPSG990899TIL16 4/1/2016 4/1/2017 DED I I RETENTION $ $ X D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) If yes, describe under DESCI RPTION OF OPERATIONS below N / A 4012016 4/1/2016 4/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 8106 Utility Infrastructure Const. Services for Water, Wastewater & Storm Water Facilities Capital Improvements. 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. �� __ {.,f11YV CLLNIIVIY City of Fort Collins 700 Wood Street Fort Collins, CO 80521-1945 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 (2014101) INS025 (201401) Mosbrucker CIC, CISR Uc 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD