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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (63)�--�� ICONENG-01 DAWNG '4c�tzo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/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 _ NAME--- - ---------- CCIG PHONE FAX 5660 Greenwood Plaza Blvd. (A/C, No, Ext): (303) 799-0110 (A/C, No):(303) 799-0156 Suite 500 rppgESS: �9• ABethF thinkcci com ADDR Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE _ NAIC k INSURED INSURER B : Pinnacol Assurance 41190 ICON Engineering Inc INSURER C Douglas Williams 7000 S Yosemite St #120 INSURER D : Centennial, CO 80112 INSURER E : INSURER F (`rl�/FRA(�FC CFDTICICATF All IMR1=0• DG111ci IAI All IMRCD• 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 SUBR POLICY NUMBER POLICY EFF Y Y POLICY EXP /DD/Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR 34SBAPD8771 01/30/2017 01/30/2018 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED R MISES (Ea occurrence) 300--- $ ,000 MED EXP (Any oneperson) _ $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PLOC OTHER. GENERAL AGGREGATE $ 4,000,000 - 4,000,000POLICY❑ $ 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 SINGLE LIMIT COMBINED ar 1,000,000 I BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAR EXCESS LIAB X I OCCUR CLAIMS -MADE i34SBAPD8771 01/30/2017 01/30/2018 EACH OCCURRENCE 2,000,000 $ AGGREGATE $ 2,000,000 DED X � RETENTION $ 10,000 B WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE (OMFFICER/MEMBER EXCLUDED? andatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below NIA I4077567 02/01/2017 02/01/2018 PER OTH- !STATUTE 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: Michaud Basin Hydrology Update 15-022-MCB-415 City of Fort Collins Attn: Beck Anderson 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD