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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (61)ICONENG-01 DAWNG ACORL� CERTIFICATE OF LIABILITY INSURANCE F-01ATE/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 i NAME: CCIG PHONE 5660 Greenwood Plaza Blvd. (A/C, No, Ext): (303) 799-0110 A/c, No :(303) 799-0156 Suite 500 E-MAIL ADDRESS: BethF thinkccig.com Greenwood Village, CO 80111 _ _ INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 rnVFRAnlI nl=DTICIY`Arr KIHRADCD. I INSURER B: Pinnacol Assurance 141190 1 ERF: 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 ADDL SUBR. POLICY EFF POLICY EXP LTR TYPE OF INSURANCE_.INSD WVD I POLICY NUMBER MMlDD/YV M/D Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE AI OCCUR 34SBAPD8771 01/30/2017 01/30/2018PREMISES EACH OCCURRENCE $ 2,000,000 (Ea occu[rence) DAMAGE TO RENTED $ 3001000 MED EXP An one Person)$ 1 O,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECRq T LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT JEaacr n 1,000,000 ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED ENON OWNED AUTOS ONLY AUTOS ONLY 34SBAPD8771 01/30/2017 01/30/2018 BODILY INJURY Perperson) _ $ -- -- $ BODILY INJURY Per accident X PROPERTY AMAGE Per accident _ A B �WORKERSCOMPENSATION IANYPROPRIETOR/PARTNER/EXECUTIVE X UMBRELLA LIAR EXCESS LIAR I X OCCUR CLAIMS -MADE N / A I 34SBAPD8771 4077567 01/30/2017 02/01/2017 I 01/30/2018 02/01/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE 2,000000 DED I X RETENTION $ 10,000 AND EMPLOYERS' LIABILITY Y/N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in f yes, describe und Iunder DESCRIPTION OF OPERATIONS below t SPTERTUTE I I OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 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) Re: Box Elder Creek SWMM Conversion - 13-036-BEC-415 City of Fort Collins Attn: Shane Boyle 700 Wood Street Fort Collins, CO 80521 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 —1— co tcv I v/vol U 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD