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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (56)----"1 ICONENG-01 DAWNG ACORO CERTIFICATE OF LIABILITY INSURANCE DATEiMM/DDIYYYY) 01 /04/2017 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 have ADDITIONAL INSURED provisions or 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. ----------------- CCIG PHONE FAX 5660 Greenwood Plaza Blvd. �_(A/C, No, Ext): (303) 799-0110 (A/c, No):(303) 799-0156 Suite 500 E-MAIIL . BethF@thinkccig.com Greenwood Village, CO 80111 INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 INSURER F : Pinnacol Assurance nnVFRAnFC CFRTIGICATF tiI IMRFR• RF\/ICIr1N M11RARFR- 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 TYPE OF INSURANCE iADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS L 1 / IY Y A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EX OCCUR _ 34SBAPD8771 0113012017 0113012018 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PR I Ea oc urre,c. 300,000 $ VIED EXP (Any oneperson) $ 10,000 PERSONAL& ADV INJURY $ 2,000,000 GENT _ AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 34SBAPD8771 01/30/2017 01/30/2018 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accdent $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 34SBAPD8771 01/30/2017 01/30/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DIED X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? [ (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below N /A 4077567 02/01/2017 02/0112018 PER OTH- T T TE E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE -EA EMPLOYEE ___ $ 1,000,000 E L DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Box Elder Creek CLOMR Review 15-011-BEC-415 City of Fort Collins Attn: Beck Anderson 700 Wood Street Fort Collins, CO 80521 CANCELLATION 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 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD