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HomeMy WebLinkAbout113618 AQUA ENGINEERING - INSURANCE CERTIFICATE (9)Client#: 1083780 AQUAENG ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/29/2018 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Colorado, LLC Prof Liab CONTACT NAME: PHONE Ell: 873-8500 nr' C, No : _ AIC No E P.O. Box 7050 Englewood, CO 80155 E-MAIL ADDRESS: _.. INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travolers Indemnity Company 25658 800 873-8500 INSURED INSURER B • Hartford Ins Co of the Midwest 37478 Aqua Engineering, Inc. INSURER C • XL Specialty Insurance Company 37885 375 East Horsetooth Road, Bldg. 2-202 INSURER D Hartford underwrifersInsurance Co(DL) 30104 Fort Collins, CO 80525-3196 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 ADDLISUBR INSR WVD _ POLICY NUMBER __ 680808528 POLICY EFF POLICY EXP WWDD/YY_YY) MM/DD/YYYY LIMITS _ $1 OOO 000 A X COMMERCIAL GENERAL LIABILITY Y Y 5/05/2018 05/05/2019 EACH OCCURRENCE PREMISES ERENTED oceu ante CLAIMS -MADE LJ OCCUR $1 000 000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ^I PRO- LOC JECTOTHER: PRODUCTS - COMP/OPAGG $2,000,000 $ D _ AUTOMOBILE LIABILITY Y Y 34UEGIS1066 5/05/2018 05/05/201 entINGLE LIMIT Ee aBcdS 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ $ - OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident A X UMBRELLA LIAR X 1 OCCUR Y Y CUP6305Y439 0510512018 05/05/2019 EACH OCCURRENCE s3,000,000 AGGREGATE s3,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N/A Y 34WEGKC2904 5/05/2018 05/05/201 X PER OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT $1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below C Professional Y DPS9922331 5/05/2018 05/05/201 $2,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insureds under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Ft. Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing DivisionPO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S22827983/M22825966 MDKZP