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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (43)ICONENG-01 LIM
CERTIFICATE OF LIABILITY INSURANCE DATE 01/091201809/2018Y)
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 CONTACT Beth Ficken
NAME: __
10 Greenwood Plaza Blvd. I pn"
5 6!cc, No, Em : (720) 212-2050 I (A/C No):(303) 799-0156
Suite 500 A M I . BethF@thinkccig.com
Greenwood Village, CO 80111_-
INSURED
ICON Engineering Inc
Douglas Williams
7000 S Yosemite St #120
Centennial, CO 80112
r_nVFRAnFC
r`FRTI1=1r`ATG All IRA01I
Insurance Grou
o��nclnr.i r.0 r�ecro.
1190
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 LIR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
RA
CLAIMS -MADE X OCCUR
X
34SBAPD8771
01/30/2018
01/30/2019
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
300,000
MED EPREMIP(Anaoneperson)
10,000
$
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY 17 jPCOT 17 LOC
GENERAL AGGREGATE
$ 4,000,000�
PRODUCTS
$ 4,000,000
_-COMP!OPAGG
OTHER:
A
AUTOMOBILE
LIABILITY
�34SBAPD8771
(CEOac.d. SINGLE LIMIT
$ 2,000,000
BODILY INJURY Perperson)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X
01/30/2018
01/30/2019
BODILY INJURY Per accident
$
X
RR
PPar a ent AMAGE
$
AUTOS ONLY X A�TOS ONLYY
A
X
UMBRELLA LIAR 1 X
OCCUR
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
EXCESS LIAB
CLAIMS -MADE
134SBAPD8771
01/30/2018
01/30/2019
DED I X RETENTION $ 10,000
$
B
WORKERS
AND EMPLOYERS' COMPEN A TIOI N
ANY PROPRIETOR/PARTNER/EXECUTIVE YEN
WE.L.
Ees, descibe uER/MEMBEREXCLUDED?
andatory in under
yand
DSCRIPTr
DION OF OPERATIONS below
NSA
4077567
02/01/2018
02/01/2019
X PER OTH-
STAT ER
EACH ACCIDENFICT
1,000,000
$
E.L. DISEASE - EA EMPLOYEE
1,0Oi,,0CC
$
E.L. DISEASE -POLICY LIMIT
1,000 � 000
i
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: 7300 Consulting Engineering Services for Clearview Channel and Future Minor Capital. As required by written contract or written agreement, the
Certificate Holder is included as Additional Insured for ongoing operations under General Liability and Automobile Liability.
L@1 a:a 1
City of Fort Collins
Attn: Pat Johnson
700 Wood Street
Fort Collins, CO 80521-1945
ACORD 25 (2016/03)
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
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD