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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (68)ICONENG-01 DAWNG ,4cc7�zo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/23/2017 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 have ADDITIONAL INSURED provisions or 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: CCIG PHONE FAX 5660 Greenwood Plaza Blvd. (A/C, No, Ext): (303) 799-0110 (A/c, No):(303) 799-0156 Suite 500 A DR'E : Beth F thinkccig.com Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC # INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 F: Pinnacol Assurance /�/l\/CDAr�CC r`CDTIl=lf ATC R1I IRADCD• RFx1IgI K1 A111MRFR• 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 LTRA TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY YFF PYYI OLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR XREMISES 34SBAPD8771 01/30/2017 01/30/2018 DAMAGE TO RENTED E Ea occurrence 300,000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 4,000,000 PRO❑LO POLICY JECT $ OTHER: A AUTOMOBILE LIABILITY MINED fCEO, acc"enISINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ ANY AUTO X 34SBAPD8771 01/30/2017 01/30/2018 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Per accident $ HIRED NON OWNED X AUTOS ONLY X AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2017 01/30/2018 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYIN ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ 4077567 02/01/2017 02/01/2018 PERT OTH- AER 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 T. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 8497 Stormwater Consulting Engineering Services As required by written contract, The City, its officers, agents and employees shall be named as additional insureds on the General Liability and Automobile Liability insurance policies for any claims arising out of worked performed under this Agreement. City of Fort Collins 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 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD