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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (225)74/3/2017
TE (MM/DD/YYYY)
AR" CERTIFICATE OF LIABILITY INSURANCE
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 CONTNAME: Kylie Carey, CISR
Flood and Peterson A/CNN Ext: (970)356-0123 FA
A/C No: (970)330-1867
PO Box 578 E-MAIL ADDRESS: KCareyCafloodpeterson.com
INSURERS AFFORDING COVERAGE NAIC S
Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623
INSURED INSURERB:Traveler8 Indemnity Company 25658
Hydro Construction Company Inc. INSURERC:Travelers Property Casualty Company 25674
301 E Lincoln Ave INSURERD:Plnnacol Assurance 41190
INSURERE:Zurich American Insurance Company 16535
Fort Collins CO 80524 INSURERF:
COVERAGES CERTIFICATE NUMBER:CL1733116969 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
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER MM! DNYYY)
(MM/DDNYYY1
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE ❑X OCCUR
A AGE TOA
PREM SESOEa occur RENTEence
$ 300,000
MED EXP (Any one person)
$ 10,000
DTC08G990899PHX16
4/1/2017
4/1/2018
PERSONAL & ADV INJURY
$ 1,000,000
GENT
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
JET LOC X
�11POLICY
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
B
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
DT8108G990899IND17
4/1/2017
4/1/2018
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
NON -OWNED
X HIRED AUTOS X AUTOS
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
C
EXCESS LIAR
CLAIMS -MADE
DED I X I RETENTION$ 10,000
$
DTSMCUP8G990899TIL17
4/1/2017
4/1/2018
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
X PER OTH-
STATUTE ER
D
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? a
(Mandatory in NH)
N/A
2091550
4/1/2017
4/1/2018
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
E
Builders Risk
PRO4012017
4/1/2017
4/1/2018
$15,000,000Limit
E
Installation Floater
PRO4012017
4/1/2017
4/1/2018
$1,000,000Limit
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Project: DWRF - South Blower Building HVAC Improvements
Certificate holder is included as Additional Insured as required by written contract with respects to
liability arising out of work performed by the named insured.
CERTIFICATE HOLDER
City of Fort Collins
300 Laporte Ave
Fort Collins, CO 80522
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
ACORD 25 (2014/01)
INS025 (201401)
N Mosbrucker CIC,CISR
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