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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (201)l , ® ACORO CERTIFICATE OF LIABILITY INSURANCE Ill DATE (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: PVHCNt o Ext : {970) 266-7149 axc, No): (970) 506-6845 Flood and Peterson 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 Hydro Construction Company Inc. INSURER C : Travelers Property Casualty Company of America 25674 INSURER D : Pinnacol Assurance 41190 77 NW Frontage Road INSURER E : INSURER F : Fort Collins CO 80524 envcRer_Fc r..FRTIFICCTF NUMBER' GUAU/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 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDY EFF MMIDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS -MADE © OCCUR DAMAGE RENTE PREM SESO(Ea occu ante) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL&ADV INJURY s 1,000,000 A DT-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 � PRO ❑ LOC FIJECT 5 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 04/01/2016 04/01/2019 BODILY INJURY (Per accident) S PROPERTY DAMAGE tPer accident $ 5 UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 5,000,000 C EXCESS LIAR CLAIMS -MADE CUP-2J40080A-18-26 04/01/2018 04i0112019 AGGREGATE S 5,000,000 DIED I X RETENTION $ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETOR/PARTNER/EXECUTIVE oFFICERIMEMBEMBER EXCLUDED? � (Mandatory In NH) NIA 2091550 04/01l2018 04/01/2019 X STATUTE ER E.L. EACH ACCIDENT 1.000,000 $ E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space Is required) RE'. 18-01-510 DWRF Sidestream Design Services 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. 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 FortCollinsCollins CO 80521-1945 <���G�tacatt @ 1988-2015 ACORD CORPORATION. All rights reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD