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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (40)ICONFNG-01 LI7R ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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 5 610 Greenwood Plaza Blvd. Suite 500 ME_-_-- CONTACT Be FlCkenCCG - - --. — AX (A/cN o,.,): (720) 212-2050 (A//C, No):(303) 799-0156 E-M REss: BethF@thinkccig.com Greenwood Village, CO 80111 INSURERS AFFORDING COVERAGE NAIC III INSURERA:The Hartford Insurance Group 22357 INSURER B : Pinnacol Assurance 41190 INSURED ICON Engineering Inc Douglas Williams INSURERC: 7000 S Yosemite St #120 INSURER D : INSURERE: Centennial, CO 80112 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTIR TYPE OF INSURANCE IADDNSD SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [ 7X OCCUR i 34SBAPD8771 01/30/2018 01/30/2019PREMISES EACH OCCURRENCE 2,00_0,0001 $_ DAMAGE TO RENTED (Ea Qcc; _ $ 300,000 MED EXP (Any one person $ 10,000 PERSONAL & ADV INJURY — $ 2,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY it _I JEPROC r-1 LOC GENERAL AGGREGATE PRODUCTS -COMP/OP AGG 4,000,000 $ 4,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 1 BODILY INJURY Per arson _ $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 34SBAPD8771 01/30/2018 01/30/2019 BODILY INJURY (Per accident) X PB08E d8 t AMAGE $ AUTOS ONLY X ALT05 ONLDY A X UMBRELLA LIAB EXCESS LIAB M 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' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4077567 02/01/2018102/01/2019 X PER OTH- TE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE _ 1 000,000 ' E.L. DISEASE -POLICY LIMIT 11000,000 i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) (Project: Michaud Basin Hydrology Update 15-022-MCB-415 CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins Attn: Beck Anderson THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street — AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521 AL;UKU 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD