No preview available
HomeMy WebLinkAbout109420 HYDRO CONSTRUCTION CO INC - INSURANCE CERTIFICATE (228)A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) T.(../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 CONTANAME.. Kylie Carey, CISR PHO N Ext: (970)356-0123 A/C No: (970)330-1867 Flood and Peterson E-MAIL ADDRESS: KCareyCifloodpeterson.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:Pinnacol Assurance 41190 301 E Lincoln Ave 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 r ADDL SUBR Y EXP POLICY EFF POLIC TYPE OF INSURANCE LTR POLICY NUMBER MM/DD/YYYY �M/DD/YYYY T LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES PREMISES Ea occurrence $ 000 MED EXP (Any one person) $ 10,000 DTC08G990899PHX16 4/1/2017 4/1/2018 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I ECT h 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 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS AUTOS _ X UMBRELLA LIAO X OCCUR EACH OCCURRENCE $ 5,000,000 REXCESS AGGREGATE $ 51000,000 C LIAB CLAIMS -MADE ED I X RETENTION$ 10,000 $ DTSMCUPBG990899TIL17 4/1/2017 1 4/1/2018 WORKERS COMPENSATION AN. EMPLOYERS' LIABILITY Y / N PER 'TH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) N f A 2091550 4/1/2017 4/1/2018 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Builders Risk PR04012017 4/1/2017 4/1/2018 $15,000,000Limit E Installation Floater PR04012017 4/1/2017 4/1/2018 $1,000,000Limit DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 17-01-439 DWRF Digester 614 Coating (Project# H-WRF-2017-6) 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. t,r-H I IrIGA I r rIULUtF4 L ArvGtLLA I IUIV City of Fort Collins 300 Laporte Ave Fort Collins, CO 80525 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) I NS025 (201401) Mosbrucker CIC,CISR��/ ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD