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130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (50)
ICONENG-01 LIZB ,acoRo CERTIFICATE OF LIABILITY INSURANCE FD 01 09/2018 ) 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 CONTACT Beth Ficken CCIG PHONE — - — FAX 5660 Greenwood Plaza Blvd. (A/C, No, Ext): (720) 212-2050 INC, No►:(303) 799-0156 Suite 500 E MAIL BethF thinkcci com Greenwood Village, CO 80111 ADDRESS: 9 INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 B:Pinnacol Assura F: Cr'1VFRAnFC RFDTIGIRATG All IMRGD• DC\/ICIr%KI AlHRADCD. 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 NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 34SBAPD8771 01/30/2018 01/30/2019 EACH OCCURRENCE $ 2,000,000 300,000 $ DAMAGE TO RENTED PR E€3 (E occur n MED EXP Any one person _. 10,000 PERSONAL & ADV INJURY 111 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JEST LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS $ 4,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea 2,000,000 $ -accident BODILY INJURY Per arson $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 34SBAPD8771 01/30/2018 01/ 30/2019 BODILY INJURY Per accident $ X (Parr accitlenDAMAGE $ AUTOS ONLY X AUUTOS ONLY $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 1 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE 34SBAPD8771 01/30/2018 01/30/2019 DED I X I RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? IMandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4077567 02/01/2018 02/01/2019 X PER OTH- T T E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE III 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: McClelland's Creek Stream Restoration 14-043-MCR-352 CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: Mark Kempton 700 Wood Street Fort Collins, CO 80521 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 REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD