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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (183)ACORN►® CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE III DATE 03; 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dana Stewart, CIC, CISR NAME: Flood and Peterson PHCONENo. (970) 266-7149 FAX (970) 506-6845 Ext : C, No A1A/ E-MAIL DStewart@floodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Phoenix Insurance Company 25623 Greeley CO 80632 INSURED INSURER B : Travelers Indemnity Company 25658 INSURER C : Travelers Property Casualty Company of America 25674 Hydro Construction Company Inc. INSURER D : Plnnacol Assurance 41190 77 NW Frontage Road INSURER E : INSURER F : Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER: GL/AU/XSIWC x4/19 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 1POLICY 1TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY EFF EXP MM DD YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE © OCCUR DAMAGE EN PREMISES (Ea occurrence300,000 S MED EXP (Any one person) $ 10,000 PERSONAL BADVINJURY S 1,000,000 A DT-CO-8G990899-PHX-18 04/01/2018 04/01/2019 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2.000,000 POLICY ❑X PRO JECT LOC PRODUCTS AGG S 2,000,000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1 .000,000 BODILY INJURY (Per person) S ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS DT-810-8G990899-IND-18 04/01/2018 04.10V2019 BODILY INJURY (Per acuden0 $ PROPERTY DAMAGE Per accident) $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5.000,000 AGGREGATE S 5.000,000 C EXCESS LIAB CLAIMS -MADE CUP-2J40080A-18-26 04/01/2018 04/0V2019 X DED RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y+N ANY PROPRIETOR/PARTNER)EXECUTIVE EylN/A OFFICER%MEMBER EXCLUDED? (Mandatory In NH) 2091550 04/01/2018 04/01/2019 X PER STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 S If yes, descnDe under DESCRIPTION OF OPERATIONS belo,, E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space Is required) RE: 916-03-419/ Project# H-WRF-2016-17 OWRF - UV System Final Clarifier Covers Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of',vork performed by the named insured. L"a:4t12L"G]l= a;Le141=IV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave AUTHORIZED REPRESENTATIVE �--}— Fort Collins CO 80522 ' �?aCG�tuatt! © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD