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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (48)A� ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 /24/2018 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 CONTACT NAME: Jim Ledbetter Hall & Company PHONE FAX 19660 10th Ave NE A/C o EXt : 360-626-2019 Alc No : 360-598-3703 Poulsbo WA 98370 ADDRESS: jedbetter@hallandcompany.com INSURERS) AFFORDING COVERAGE I NAIC # RLI INSURANCE COMPANY 1 13056 INSURED 732 Icon Engineering Inc 7000 S Yosemite Street, Suite 120 Centennial CO 80112 COVFRAt;FR CFRTIFICATF N1JMBER:419379474 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' TYpE OF INSURANCE 'ADDL'SUBR POLICY EFF POLICY EXP LIMITS LTR '�,IN WV POLICY NUMBER MM/DD/WYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO PREMISES Ea occcu ante $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ POLICY E PRO ❑ JECT LOC $ PRODUCTS - COMP/OP AGG OTHER: 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS $ BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE EXCESS LIAR $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below I I I $ A Professional Liab: Claims Made RDP0031478 1/30/2018 1/30/2019 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Additional Insured Status is not available on Professional Liability Policy. Second Street Drainage Improvements - 17-008-SEC-352 CERTIFICATE HOLDER CANCELLATION City of Fort Collins 700 Wood Street Fort Collins CO 80525 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. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD