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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (197)A� 1 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/Y) o3;2s/2018zola 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 PHONE (970) 266-7149 FAX {970} 506-6845 A1C No Ext : A/C, No E-MAIL DStewart@floodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA: Phoenix Insurance Company 25623 INSURED INSURER B : Travelers Indemnity Company 25658 INSURER C : Travelers Property Casualty Company of America 25674 Hydro Construction Company Inc. INSURER D : Pinnacol Assurance 41190 77 NW Frontage Road INSURER E : INSURER F : Fort Collins CO 80524 P.nVFRArFC RFRTIFICATF NtIMRFR- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM OD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 ®OCCUR PREIRENTED DAICLAIMS-MADE M SESO'Ea occurrence g 300,000 NIED EXP (Any one person) $ 10,000 PERSONAL&ADV INJURY $ 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 PRO ❑ LOC JECT PRODUCTS-CON•1P/OP AGG S 2,000,000 S OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accidents $ 1,000,000 BODILY INJURY (Per person) s ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY DT-810-8G990899-IND-18 04/01/2018 04/01/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident S 5 UMBRELLA LIAB I X1 OCCUR EACH OCCURRENCE S 5,000,000 C EXCESS LIAB CLAIMS -MADE CUP-2J4008OA-18-26 04/01/2018 04i01/2019 FI AGGREGATE S 5.000,000 DED I X1 RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIVE F OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N t A 2091550 04I0112018 04/01I2019 X STATUTE EORH E.L.EACH ACCIDENT S 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 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: 18-01-499 DWRF Dewatering & Sludge Strain Press Construction City of Fort Collins is included as Additional Insured on the General, Automobile. and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. (;EKIWICAlh HL)LUtK t,ANt,CL.L.AIlUN 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. 700 Wood Street AUTHORIZED REPRESENTATIVE Fort Collins CO 80521-1945 Y © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD