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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (44)ICONENG-01 LIZB '4coRv CERTIFICATE OF LIABILITY INSURANCE DAT1/09/10182018 ) �-� 0/09 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 RA . CCIG PHONE TFAX 5660 Greenwood Plaza Blvd. (A/C, No, Exty (720) 212-2050 I (A/c, No):(303) 799-0156 Suite 500 X&IESS: BethF@thinkccig.com Greenwood Village, CO 80111 INSURERS AFFORDING COVERAGE NAIC # INSURERA:The Hartford Insurance Group 22357 INSURED INSURER B : Pinnacol Assurance 41190 ICON Engineering Inc Douglas Williams INsuRERc: 7000 S Yosemite St #120 INSURER D : Centennial, CO 80112 INSURERE: INSURER r : CAVFRAnFA CFRTIFIr_ATF Alt IMRFR• CCVICIr%KI IVI lI1ACCO- 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. NSR IADDL TYPE OF INSURANCE INSD SUER WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 34SBAPD8771 01/30/2018 01/30/2019 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES rren _ 300,000 A--- MED EXP (Any oneperson) $ 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY ] PE LOC GENERAL AGGREGATE 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 OTHER A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident) 2,000,000 BODILY INJURY Perperson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY ' AUTOS X 34SBAPD8771 01/30/2018 01/30/2019 BODILY BODILY INJURY Per accident $ X �� PPe�acEcitleTMrK AMAGE $ AUTOS ONLY X A�NO ONLY A MBRELLA LIAB ESSLCLAIMS-MADE X OCCUR 34SBAPD8771 01/30/2018 01/30/2019 EACH OCCURRENCE $ 2,000,000 4E'C AGGREGATE 2,000,000 ED X RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH) EXCLUDED? (Mandatory in and DIf yes, describe under DESCRIPTION OF OPERATIONS below NIA 4077567 02/U1/2018 02/U1/2019 I OTH- TAT1 ER 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: 8497 Stormwater Consulting Engineering Services As required by written contract, The City, its officers, agents and employees shall be named as additional insureds on the General Liability and Automobile Liability insurance policies for any claims arising out of worked performed under this Agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins 700 Wood Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE I As_,VMU ZD (Lu lo/ua/ ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD