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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (60)ICONENG-01 DAWNG
ACORL7 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
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
CCIG PHONE FAX
5660 Greenwood Plaza Blvd. (A/C, No, Ext): (303) 799-0110 (A/c, No):(303) 799-0156
Suite 500 E-MAIL BethF thinkcci com _
Greenwood Village, CO 80111 �E� @�„�� g����„��- „
INSURED
ICON Engineering Inc
Douglas Williams
7000 S Yosemite St #120
Centennial, CO 80112
E:
F:
CnVFRAnFR CFRTIFICGTF NI IMRFR• RFVICInN NI IMRFR-
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
ADDL
St.
POLICY NUMBER
POLICY EFF
/ /
POLICY EXP
I D/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
34SBAPD8771
01/30/2017
01/30/2018
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
PREMISES a occurrence)
300,000
$
ME EXP (Any oneperson)
$ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY JJEC 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 NON0WNED
AUTOS ONLY AUTOS ONLY
34SBAPD8771
01/30/2017
01/30/2018
COM.
cc,dentSINGLE LIMIT
$ 1,000,000
BODILY INJURY Perperson)
$___
BODILY INJURY Per accident
_
$
X
PROPERTY DAMAGE
Per accident
$
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
DED I X RETENTION $ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
IOFFICER/MEMBER EXCLUDED?
(Mandatory,nNH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
4077667
02/01/2017
I
02101/2018
PER OTH-
TAT
E.L. EACH ACCIDENT
1,000 000
$ '
E.L DISEASE -EA EMPLOYEE'
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
1,000,000
$
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Project: Canal Importation H & H Peer Review 14-024-CIB-415
City of Fort Collins
Attn: Shane Boyle
700 Wood Street
Fort Collins, CO 80525
C�L`iy3��t�II�1►1
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