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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (65)ICONENG-01 DAWNG
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 -MAIL ppgEr,s: BethF@thinkccig.com
Greenwood Village, CO 80111 -^
INSURED
ICON Engineering Inc
Douglas Williams
7000 S Yosemite St #120
Centennial, CO 80112
INSURER F :
CnVFRAnFA RFRTIFIr ATF NII IMRFR• 0C1/Iclnht K11IaaDC10-
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
JJ&Y
TYPE OF INSURANCE
ADDL
IS
POLICY NUMBER
POLICY EFF
POLICY EXP
/V
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
I _7
EACH OCCURRENCE $ 2,000,000
DAMA'EMGE TO RENTc.ED $ 300,000
CLAIMS -MADE X OCCUR
34SBAPD8771
01/30/2017
01/30/2018
MED EXP (Any oneperson) $ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY jPCOT 7 LOC
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS - COMP/OP AGG
4,000,000
OTHER
A
AUTOMOBILE
LIABILITY
COMBINdEDiSINGLE LIMIT
$ 1,000,000
BODILY INJURY Perperson)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
34SBAPD8771
01/30/2017
01/30/2018
BODILY INJURY Per accident
$
X
PROPERTYDAMAGE
Per accident
$
HIRED X NONOyyNED
AUTOS ONLY AUTOS ONLY
A
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
EXCESS LIAB
CLAIMS MADE
34SBAPD8771
01/30/2017
01/30/2018
DED I X I RETENTION $ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / NLITE_
ANY PROPRIETOR/PARTNER/EXECUTIVE
WFICER/MEMBER EXCLUDED? El
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
4077567
02/0112017
02/01/2018
PER OTH-
E.L. EACH ACCIDENT
1000 000
,
$ '
El, DISEASE - EA EMPLOYEE
_
$ 1,000,000
--
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
Project: Stanton Creek Stabilization 14-042-SCS-352
City of Fort Collins
Attn: Mark Kempton
700 Wood Street
Fort Collins, CO 80521
CAN
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
N.:.�'L•- /`'"lam
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD