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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (28)P5260028002 ACC)IiR1Y 1110�CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 03/24/2016 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 IMA, Inc. - COlOi8d0 D1v18i0II CONTACT NAME: PHONE FAX A/C No): 1705 17th Street E-MAIL denaccounttechs6imacO ADDRESS: rp•Com INSURERS AFFORDING COVERAGE NAIL 0 Suite 100 INSURER A: PHOENIX INS CO (Travelers) 25623 Denver, CO 80202 INSURED INSURERS: TRAVELERS IND CO OF AMR 25666 Hydro Construction Company, Inc. INSURER C : TRAVELERS PROP CAS CO OF AMER 25674 INSURERD: PINNACOL ASSUR 41190 301 East Lincoln Avenue INSURER E : INSURERF; Fort Collins, CO 80524 1 COVERAGES CERTIFICATE NUMBER: 46396128 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 NMIDD POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR DTC04E216873PHX15 04/01/15 04/01/16 EACH OCCURRENCE $ 1,000,000 ETD PREMISES Ea occurrence S 300,000 X MED EXP (Any one person) $ 10,000 PD Ded: $5, 000 PERSONAL BADVINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT 7 LOC GENERAL AGGREGATE $ 2,000,000 GENI PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY DT8104E216873IND15 04/01/15 04/01/16 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ C X UMBRELLA LIAB X JOCCUR DTSMCUP4E216873TIL15 04/01/15 04/01/16 EACH OCCURRENCE $ 2,000,000 EXCESS LAB CLAIMS -MADE AGGREGATE $ 2,000,000 DED 1 X I RETENTION$ 10, 0 0 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED4 N❑ NIA 2091550 04/01/15 04/01/16 TUPER OTH- X STATE 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 I LOCATIONS / 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 the policy terms and conditions. RE: FCWTF Chlorine Contact Basin Phase 3; SCP-WTFCCB3-032816. City of Fort Collins 700 Wood Street Fort Collins, CO 80521 USA 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 MR ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD spmaestas 46396128 O z LU