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130088 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