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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (53)ACoR" CERTIFICATE OF LIABILITY INSURANCE 1/29/2017 MI DIYYYY) 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 endorsements . PRODUCER CONTNAME.' _Jim Ledbetter _ Hall & Company PHONE 360-626-2019 FAXC. 360-598-3703 19660 10th Ave NE E-MAIL hallandcom an Poulsbo WA 98370 ADDRESS: led better @ P Y•com INSURERA:RLI INSURANCE COMPANY 13056 INSURED 732 INSURER B : Icon Engineering Inc INSURERC: 7000 S Yosemite Street, Suite 120 INSURERD: Centennial CO 80112 INSURER E rnvcDAncc P`00TICIe AT0 kilIIIADCo. On'1A7Rrr,'2r, ­.n­ 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER EFF MM DID/YYYY I POLICY XYY MM DDNYCY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ a DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GENT POLICY ❑ PRO - POLICY LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED S17=1nVI7__ Ea accident $ BODILY INJURY (Per person) $ ANY AUTO AUTOSNED SCHEDULED BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N I STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ A Professional Liab: Claims Made RDP0027679 1/30/2017 1/30/2018 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured Status is not available on Professional Liability Policy. Project: First Street Outfall 15-008-FSO-352 L.tK I II -It A I t MULUtK LANUt=LLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 700 Wood Street ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 80521 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD