HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (203)ACOROa CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
03,12912018
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
Flood and Peterson
PO Box 578
Greeley CO 80632
CONTACT Dana Stewart. CIC, CISR
NAME:
A C. Exc : (970} 266-7149 AIXC. Nv : (970) 506-6845
E-MAIL DStewart@floodpeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Phoenix Insurance Company
25623
INSURED
Hydro Construction Company Inc.
77 NW Frontage Road
Fort Collins CO 80524
INSURER B : Travelers Indemnity Company
25658
INSURER C : Travelers Property Casualty Company of America
25674
INSURER D : Pinnacol Assurance
41190
INSURER E :
INSURER F :
rnV9:PAG_ES CERTIFICATE NUMBER- 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
ADDLSUBRPOLICY
INS
WVD
POLICY NUMBER
EFF
MMIDD/YYYY
POLICY EX P
MMIDDIYYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE F_x] OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence'
S 300,000
MED EXP (Any one person)
$ 10,000
A
DT-CO-8G990899-PHX-18
04/01/2018
04/01/2019
PERSONAL&ADV INJURY
S 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - CObtPIOP AGG
S 2.000,000
POLICY PEA LOC
OTHER.
S
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accidend
$ 1,000,000
BODILY INJURY (Per person)
S
ANY AUTO
BODILY INJURY (Per accident)
$
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
AUTOS ONLY AUTOS ONLY
r,X. HIRED NON -OWNED
DT-810-8G990899-IN D-1 8
04/01/2018
04/01/2019
PROPERTY DAMAGE
(per accident)
S
5
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
S 5.000,000
C
EXCESS LIAB
CLAIMS -MADE
CUP-2J40080A-18-26
04/01/2018
04/01/2019
AGGREGATE
$ 5,000,000
DED I X1 RETENTION $ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE Y
OFFICERWEMBER EXCLUDED?
(Mandatory In NH)
NIA
2091550
04/01/2018
04/01/2019
PER
/� STATUTE ERH
E.L. EACH ACCIDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1.000,000
E.L. DISEASE -POLICY LIMIT
$ 1.000,000
It yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
RE: 18-01-502 DWRF - Non -pot Strainer Replacements
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.
FICATE HO
City of Fort Collins
700 Wood Street
Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORED REPRESENTATIVE
CO 80521-1945 I '
U 1988-2015 AGOKD GUKVUKAI IUN. Ali ngnrs reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD