HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (190)ACORN® CERTIFICATE OF LIABILITY INSURANCE
�.
GATE (MM/DDIYYYY)
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
q C NNo Ext : (970) 266-7149 ac, No : (970) 506-6845
E-MAIL DStewart@floodpeterson.com
ADDRESS:
PO Box 578
INSURER($) 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 0: Pinnacol Assurance
41190
77 NW Frontage Road
INSURER E :
INSURER F :
Fort Collins CO 80524
CnVCRAn=C rTFRTIFIRATF NIIMRFR• GL/AU/XS/WC 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.
INSR
LTR
TYPE OF INSURANCE
ADOLSUOR
INSD
WVD
POLICY NUMBER
POLICY EFF I
MM/DDIYYYY
POLICY EXP
MM/DDIYYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
5 1,000,000
DAMAGE E TORENTED
300.000
CLAIMS -MADE OCCUR
PREMISES'Ea occurrence
S
dgED EXP (Any one person)
$ 10,000
PERSONAL&ADV INJURY
S 1.000,000
A
OT-CO-8G990899-PHX-18
04/01/2018
04/01?2019
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2.000,,000
PRODUCTS-COMPIOPAGG
S 2.000,000
POLICY JET LOC
S
OTHER.
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
S
ANY AUTO
B
OWNED SCHEDULED
DT-810-8G990899-IND-18
04/01/2018
04/01/2019
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
PROPERTY DAMAGE
S
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
fPer accident)
5
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
C
EXCESS LIAB
CLAIMS-NIADE
CUP-2J40080A-18-26
04/01/2018
04/01/2019
AGGREGATE
S 5,000,000
DED I X RETENTION $ 10,000
$
WORKERS COMPENSATION
H
X STATUTE ER
AND EMPLOYERS' LIABILITY Y I N
E.L. EACH ACCIDENT
$ 1.000,000
O
ANY PROPRIETOR/PARTNERIEXECUTIVE
7
NIA
2091550
04/01l2018
r
04;01,2019
1,000'000
OFFICER+MEMBER EXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
S
E.L. DISEASE - POLICY LIMIT
5 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Project: DWRF - South Blower Building HVAC Improvements
Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named
insured.
!`COTICId'ATC unl nco r.ANCFI I ATIAN
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`
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