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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (66)ICONENG-01 DAWNG 144c"R" CERTIFICATE OF LIABILITY INSURANCE MM FDATE71DD/YYYY) 01 /04/2017 011042017 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 CCIG 5660 Greenwood Plaza Blvd. Suite 500 Greenwood Village, CO 80111 CONTACT P ONE FAX A/c, No, Ext): (303) 799-0110 IA/c, No :(303) 799-0156 E-M AIL ADDRESS, BethF@thinkccig.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:The Hartford Insurance Group 22357 INSURED INSURER B : Plrinacol Assurance 41190 ICON Engineering Inc Douglas Williams INSURER C : -- - 7000 S Yosemite St #120 INSURER D : INSURERS: Centennial, CO 80112 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 I TYPE OF INSURANCE ADDL I SUBR POLICY NUMBER POLICY EFF POLICY EXP ry Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE CI OCCUR 34SBAPD8771 01/30/2017 01/30/2018 EACH OCCURRENCE $ 2,000,000 DRAMAGETORENTIEDn $ 300,000 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JE T 4,000,000 $ PRODUCTS -CO COMP/OP PRODUCTS -COMP/OP AGG 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE 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 $ AUTOS ONLY X A�TOS ONL� __ 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 RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDE D9 ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4077567 02/01/2017 02/01/2018 PER OTH- T E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,00o,006 E.L DISEASE - POLICY LIMIT $ 1,000,000 I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: West Vine Basin Hydrology Update 15-021 -WVB-41 5 %,E:m I IriL H I c MULUCK CANCELLATION 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 AGUKU 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD