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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (37)ICONENG-01 LIM ACORN° CERTIFICATE OF LIABILITY INSURANCE D 01 09/2018 ) �•--� 01 /09/2018 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 i CONTA NAME:CT Beth Ficken CCIG PHONE FAX 5660 Greenwood Plaza Blvd. (A/C, No, Ext): (720) 212-2050 (A/c, No :(303) 799-0156 E-MAISuite 500 A00R SS: Beth%thinkccig.com Greenwood Village, CO 80111 1 , -__ ..... - INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 F Pinnacol Assurance nnVFRAnFR (FRTIFIr`ATF NI IMRFR• RFVICIC)NI NI IMRFR- 41190 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR 34SBAPD8771 01/30/2018 01/30/2019 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 300,000 MED EXP (Any one $ 10,000 person PERSONAL & ADV INJURY 2,000,000 $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ j�T 1 LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED ONLY X AUOTOS ONED 34SBAPD8771 01/30/2018 01/30/2019 COMBINED SINGLE LIMIT $ 2,000,000 BODILY INJURY Perperson) $ INJURY Per accident $ X -BODILYBOODILY PROP.E ldeM AMAGEAUTO $ A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE !34SBAPD8771 01/30/2018 01/30/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Yj� OEXCLUDED? `� (MFFICER/MEMBER 3n .R!nry it NH) If ees DESs, dCRIPcribe under TION OF OPERATIONS below N/A i 4077567 02/01/2018 02I0112019 X PER OTH- E E.L. EACH ACCIDENT - 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,OOC E.L. DISEASE -POLICY LIMIT _ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Project: West Vine Basin Hydrology Update 15-021-WVB-415 City of Fort Collins Attn: Beck Anderson 700 Wood Street Fort Collins, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED DRREPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD