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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (226)AC� ® 74/3/2017 TE (MM/DDNYYY) AC� 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 NAME: CT Kylie Carey, CISR Flood and Peterson PHONE N E (970)356-0123 aC (AACNo:(970)330-1867 PO Box 578 E-MAILannaccc•KCareyCa£loodpetersoa.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INSURERB:Travelers indemnity Company 25658 Hydro Construction Company Inc. INSURERC:Travelers Property Casualty Company 25674 301 E Lincoln Ave INSURERD:Pinnacol Assurance 41190 INSURERE:Zurich American Insurance Company 16535 Fort Collins CO 80524 INSURERF: CnVFRAGFS CFRTIFIr ATF NIIURFR•CL1733116969 RF\/IC1fl Al Kill IRACCQ- 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 ADDLI INSD SUM WVD � POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 DTCOBG990899PHX16 4/1/2017 4/1/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO - POLICY ECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1, 000, 000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS DT8108G990899IND17 4/1/2017 4/1/2018 BODILYINJURY(Peraccident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident _ $ X UMBRELLA LIAB 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 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) If yes, describe under N/A 2091550 4/1/2017 4/1/2018 X STPER OTH- ATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Builders Risk PRO4012017 4/1/2017T /l/2018 $15,000,000Limit E Installation Floater PRO4012017 4/1/201,/1/2018 $1,000,000Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: 17-01-425 DWRF UV System Construction (Project #H-WRF-2016-19) Certificate holder and Carollo Engineers, Inc. (10822 W Toller Dr, Suite 200, Littleton, CO 80127) are included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. --cm i Ir'II,A I C 19ULLJCIl t AN1,rLLA 1 IL)N 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 N Mosbrucker CIC,CISR ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)