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HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (227)AC "R" CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
4/3/2017
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
CONTACT NAME: lie Carey, CISR _
taCNo.Ext): (970)356-0123 A/C No:(970)330-1867
Flood and Peterson
E-MAIL ADDRESS: KCarey@floodpeterson.com
PO Box 578
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:Phoenix Insurance Company
25623
Greeley CO 80632
INSURED
INSURERB:Travelers indemnity Company
25658
INSURERC:Travelers Property Casualty Company
25674
Hydro Construction Company Inc.
INSURERD:Plnnacol Assurance
41190
301 E Lincoln Ave
INSURERE:Zurich American Insurance Company
16535
INSURERF:
Fort Collins CO 80524
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.
- -- --- - — --POLICY - -
INSR AODL SUBR POLICY EFF EXP LIMITS
LTR TYPE OF INSURANCE WyJLPOLICY NUMBER MM/OD/YYYY � MM/DD/VYY
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE �X OCCUR
DAMAGE
PREM SESOEaRENTED
encoccurre
$ 300,000
IVIED EXP (Any one person)
$ 10,000
DTC08G990899PHx16
4/1/2017
4/1/2018
PERSONAL 8 ADV INJURY
$ 11000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY RO-
� JECT1:1 LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
EA
$ 1,000,000
-accident
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 X I RETENTION$ 10,000
$
DTSMCUPSG990899TIL17
4/1/2017
4/1/2018
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED, ❑N
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NSA
2091550
4/1/2017
4/1/2018
X PER H-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE
_--
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
1 $ 1,000,000
E
Builders Risk
PRO4012017
4/1/2017
4/1/20113
$15,000,000 Limit
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)
RE: #16-03-419/ Project# H-WRF-2016-17 DWRF - W System Final Clarifier Covers
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 CANCELLAFIUN
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)
Mosbrucker CIC,CISR
©1988-2014 ACORD CORPORATION. All rights reserved.
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