Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (38)�-1 ICONENG-01 LIZB
ACORO DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 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 suchpendorsement(s).
PRODUCER NAME CT Beth Ficken
CCIG
5660 Greenwood Plaza Blvd. PHONE FAX, , Et): (720) 212-2050 (A/C No):(303) 799-0156
Suite 500 E-MAIL , BethF@thinkccig.com
Greenwood Village, CO 80111 ccnomur_ rnvconr_c un,r r
INSURED
ICON Engineering Inc
Douglas Williams
7000 S Yosemite St #120
Centennial, CO 80112
rn11FRARFC rFRTIFIrATF NI IMRFR• RFVISICIN NI IMRFR-
411
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 TYLTR PE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF 1 POLICY EXP LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
34SBAPD8771
01/30/2018
01/30/2019
EACH OCCURRENCE
$ 2,000,000
DAMAGE TORENTED
PR MBE urrence
— 300,000
$
MED EXP (Any one arson
$ 10,000
_
PERSONAL & ADV INJURY
$ 2,000,000
_
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY � jE LOC
OTHER:
GENERAL AGGREGATE
$ 4,000,600
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X AUTOS ONLY X AUOTOS ONLY
134SBAPD8771
01/30/2018
01/30/2019
COMBINED SINGLE LIMIT
(Ea accident)$
2,000,000
BODILYINJURY(Per erson
$
BODILY
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
34SBAPD8771
01/30/2018
01/30/2019
EACH OCCURRENCE_
$ 2,000,000
AGGREGATE
$ 2,000,000
DED X I RETENTION $ 10,000
B
WORKERS COMPENSATION
ANDEMPLOYERS' LIABILITY
Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
((Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N /A
4077567
02/01/2018
02/01/2019
X PTAT T OTH-
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
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: First Street Outfall 15-008-FSO-352
l�fa:a�IRI�fG\�3ila1Mo13► h_VLha,AG\$La1►
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 REPRESENTATIVE
_
ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD