HomeMy WebLinkAbout113618 AQUA ENGINEERING INC - INSURANCE CERTIFICATE (6)r CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
04/07/2018
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 SUBROGATIONIS 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:
USI COLORADO LLC/PHS
34343366
sac N ,Ext: 866 467-8730
)
FAx
(A/C, No).(888) 443-6112
E-MAIL
THE HARTFORD BUSINESS SERVICE
ADDRESS
INSURER(S) AFFORDING COVERAGE NAICW
CENTER
INSURER A: Hartford Fire and Its P&C Affiliates
0091
3600 WISEMAN BLVD
SAN ANTONIO, TX 78265
INSURED
INSURER B :
AQUA ENGINEERING, INC.
INSURERC:
4803 INNOVATION DR
INSURER D :
FORT COLLINS CO 80525-7307
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
INSR
SUB
WVD
POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
AMkVDD)YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE ❑OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
POLICY ❑PRO- ❑ LOC
JEGT
PRODUCTS - COMP!OP AGG
$
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
accident
$
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
HIRED AUTOS NON -OWNED
AUTOS
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS UAB
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS UABILnY
Y/N
ruTFF
S LALUTE X ER
$
E.L. EACH ACCIDENT
$ 1,000,000
A
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFRGFR/MFMBFR EXCLUDED?
M A
34 W EG KC2904
05/05/2018
05/05/2019
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
(Mandatory In NH)
It yes. describe under
F.L. DISEASE - POLICY LIMIT
$ 1 ,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Those usual to the Insured's Operations_
rPiznRr-ATr: "t-ii nm CANCELLATION
CITY OF FT COLLINS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
PURCHASING DIVISION
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
THE POLICY PROVISIONS.
PO BOX 580
AUTHORIZED REPRESENTATIVE
FORT COLLINS CO 80522-0580
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O 1988-2015 ACORD CORPORATION_ All rights reserved.