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HomeMy WebLinkAbout113618 AQUA ENGINEERING INC - INSURANCE CERTIFICATE (8)CI ient#: 1083780 AQUAENG ACORD„- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 4/11/2017 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 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 USI Colorado, LLC Prof Liab P.O. Box 7050 Englewood, CO 8O15S 800 73-85 873-8500 CONTACT NAME: FAX A o Ext , 800 873-8500 (A/C, No): E-MAIL ADDRESS: _ _ __ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Indemnity Company 25658 INSURED INSURER B : Hartford Ins Co Of the Midwest 37478 Aqua Engineering, Inc. INSURER c : XL Specialty Insurance Company 37885 375 East Horsetooth Road, Bldg. 2-202 INSURER D : Hartford Underwriters Insurance 30104 Fort Collins, CO 80525-3196 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 LTR TYPEOFINSURANCE ADDL'SUBR INSR WVD POLICY_ NU_MBE_R_ POLICY EFF MM/DD 5/05/2017 POLICY EXP MM/DD/YYYY 05/05/2018 LIMITS EACH $1, 000,000 A X COMMERCIAL GENERAL LIABILITY Y Y 680808528 CLAIMS -MADE � OCCUR $1 OOO 000 ��OCCURRENCE PREMISES (Ea occu ence MED EXP (Any one person) $1 O 000 PERSONAL BADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY LX] JECT F7 LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: D AUTOMOBILE LIABILITY Y Y 34UEGIS1066 5/05/2017 05/05/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO IX ALL OWNED SCHEDULED AUTOS AUTOSHIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ - A X' UMBRELLA LIAB X I OCCUR Y Y CUP6305Y439 5/05/2017 05/05/2018 EACH OCCURRENCE s3,000,000 AGGREGATE EXCESS LUIB CLAIMS -MADE s3,000,000 DED FX RETENTION$10000 $ B I WORKERS COMPENSATION j AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE �Y �,,,� OFFICER/MEMBER EXCLUDED? N / A Y 34WEGKC2904 5/05/2017 05/05/2018 X PERT T OTH E.L. EACH ACCIDENT — — - $1 000,000 - ---- E.L. DISEASE - EA EMPLOYEE $1 00O 000 L'J (Mandatory in NH) If Yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1 ,000 O00 _ C Professional Y _ DPS9804543 5/05/2016 05/05/201 $2,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insureds under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Ft. Collins Purchasing DivisionPO Box 580 Fort Collins, CO 80522-0580 I IUN 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 \i ACORD 25 (2014/01) 1 Of 2 #S20280760/M20280113 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BTRZP