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 (42)i-� ICONENG-01 LIZB
ACORN' 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 CQNTACT Beth Ficken
_ _
CCIG PHONE FAX
5660 Greenwood Plaza Blvd. I (A/C, No, Ext : (720) 212-2050 (Arc, No :(303) 799-0156
Suite 500 rE-MAIL
ADDRESS: BethF@thinkccig.com
Greenwood Village, CO 80111 I -
INSURED
ICON Engineering Inc
Douglas Williams
7000 S Yosemite St #12
Centennial, CO 80112
CCIVFRAAFR—_—.---__—_--
rFRTIFIrATF NI IMRFR-
INSURERA:The Hartford Insurance
INSURER B : Pinnacol Assurance
INSURER C :
INSURER D :
INSURER E :
I INSURER F
Group
RFVIRIr1Nl III IMRFR-
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 SUER POLICY NUMBER
POLICY EFF POLICY EXP LIMITS
A
X
I COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE '- I OCCUR
_
34SBAPD8771
01/30/2018
01/30/2019
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISE$ LEa occurrence)
MED EXP Aone person
nem
$ 2,000,000
300,000
$ _
$ 10'000
_
PERSONAL & ADV INJURY
$
2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECT LOC
GENERAL AGGREGATE
$
4,000,000
_
PRODUCTS - COMP/OP AGG_
$
_ _ 4,000,000
OTHER:
$
A
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$___
2,000,000 11
_CEaaccidant)
BODILY INJURY Per erson
$
ANY AUTO
AWNED SCHE
UTOS ONLY AUTOSULED
34SBAPD8771
01/30/2018
01/30/2019
BODILY INJURY Per accident
X
PROPERTY DAMAGE
Per accident
$
HIRED X NUT16 WTED
AUTOS ONLY AUTOS ONLY
I
— _
A
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$
2,000,000
AGGREGATE
$
2'007
EXCESS LIAR
CLAIMS -MADE
34SBAPD8771
01/30/2018
01/30/2019
DED X RETENTION $ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' 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 PER OH -
T R
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)
RE: General Consulting Services. P1044 Consulting Engineering Services W. Orchard Pond and Storm Drainage Project and Future Stormwater
Minor Capital Improvements.
Facilities
CERTIFICATE HOLDER
CANCELLATION
_
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins Purchasing Department
215 N Mason St 2nd Floor
THE EXPIRATION DATE THEREOF, NOTICE WILL BE
ACCORDANCE WITH THE POLICY PROVISIONS.
DELIVERED IN
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
ACQKLI 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD