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130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (62)
ICONENG-01 DAW ,4coRn► CERTIFICATE OF LIABILITY INSURANCE 7 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 riqhts to the certificate holder in lieu of such endorsement(s). PRODUCER CCIG 5660 Greenwood Plaza Blvd. Suite 500 Greenwood Village, CO 80111 INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 ia/c'rio. Eztt: (303) 799-0110 in"/c. Not:(303) 799-0156 I INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP /Y _ LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 34SBAPD8771 01/30/2017 01130/2018 EACH OCCURRENCE 000 ,, 2000 $ DAMAGE TO R(EaENTED occurrence)$ _ 300,00PREMISES0 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: HF_7 POLICY C JE 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-OWNEp AUTOS ONLY AUTOS ONLY i 34SBAPD8771 0113012017 01/30/2018 COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 BODILY INJURY Per person)$ 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 DIED I X i RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ OFFICndatory in NH) ER/MEMBER EXCLUDE (MaD? If yes, describe under DESCRIPTION OF OPERATIONS below N / A 14077567 1 02/01/2017 02/01/2018 ER OTH- 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) Re: Project - Poudre River Damage Assessments 13-026-PRD-415 City of Fort Collins Attn: Shane Boyle 700 Wood Street Fort Collins, CO 80525 LK_L`C+i:11111A_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