HomeMy WebLinkAbout113618 AQUA ENGINEERING INC - INSURANCE CERTIFICATE (7)- CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
03/27/2018
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 be endorsed. If SUBROGATIONIS 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
NAME: _
USI COLORADO LLC/PHS
34343366
PHONE
(A/c, No, Exq: 866 467-8730
FAX
(a c, No): (888) 443-6112
E-MAIL
THE HARTFORD BUSINESS SERVICE
ADDRESS
INSURER(S) AFFORDING COVERAGE NAIC#
CENTER
3600 WISEMAN BLVD
INSURER A c Hartford Fire and Its P&C Affiliates
0091
SAN ANTONIO, TX 78265
INSURED
INSURER B :
AQUA ENGINEERING, INC.
INSURERC:
4803 INNOVATION DR
FORT COLLINS CO 80525-7307
INSURERD:
INSURERE:
INSURER F :
COVERAGES CERTIFICATF NIJMRFR- RCVICInIJ NI IuRGR-
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.
INSH
TYPE OF INSURANCE
ADDL
INSR
SUB
WVD
POLICY NUMBER
POLICY EFF
(MwDD/YYY Y)
POLICY EXP
MMr'DDiYYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE ❑OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$
MED EXP (Any Otte person)
$
PERSONAL & ADV INJURY
$
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
fEa accidentl
$
ANY AUTO
BODILY INJURY Per ( person)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident }
$
HIRED AUTOS NON -OWNED
AUTOS
PROPERTY DAMAGE
(Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
$
DED I I RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
P -
STATUTE X ER
$
E.L. EACH ACCIDENT
$ 1,000,000
A
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICERWEMBER EXCLUDED?
(Mandatory in NH)
w A
34 W EG KC2904
05/05/2018
05/05/2019
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
If yes, describe under
E.L.. DISEASE -POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS below
$
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be anacbed it more space is required)
Those usual to the Insured's Operations.
CERTIFICATE HOL DER CANr_FI I ATITIN
PO BOX 580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
FORT COLLINS CO 80522-0580
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
THE POLICY PROVISIONS-
AUTHO�REZED REPRESENTATIVE
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