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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (67)ICONENG-01 DAWNG
A� o�Ro 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
�L-ME_—--
CCIG ;PHONE, FAX
5660 Greenwood Plaza Blvd, A/C, No, Ext►: (303) 799-0110 Io/c, No):(303) 799-0156
Suite 500 RaMAIL RESS: BethF@thinkccig.com
Greenwood Village, CO 80111
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A:The Hartford Insurance Group 22357
INSURED INSURER B : Plnnacol Assurance 141190
ICON Engineering Inc
Douglas Williams
7000 S Yosemite St #120
Centennial, CO 80112
F-
I INSURER F :
CnVFRAnPR 1^_FRTICII^ATG All Ii11109:11I r,, —
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
TYPE OF INSURANCE
ADD
SiNsk UER,
POLICY NUMBER
POLICY EFF
I /YY
POLICY EXP
l I Y
-
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
34SBAPD8771
01/30/2017
01/3012018
EACH OCCURRENCE
' $ 2,000,000
DAMAGE TO RENTED PREMISES Ea Occurrence)$
300,000
MED EXP (Any one person)
$ 10,000
— --�
PERSONAL & ADV INJURY
$ 2,000,000
GENT
AGGREGATE LIMIT APPLIES PER:
POLICY 171 JERCo T I LOC
GENERAL AGGREGATE
4,000,000
$______
I
I
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
accident)
$ 1,000,000
BODILY INJURY Perperson)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AU�TOpSyVNEp
AUTOS ONLY X AUTOS ONLY
34SBAPD8771
01/30/2017
01/3012018
BODILY INJURY Per accident
$
X
PerOaccitlentDAMAGE
$
A
X
UMBRELLA LIAB
X
JOCCUR
EACH OCCURRENCE
2,000,000
AGGREGATE
$ 2,000,000
EXCESS LIAR
ICLAIMS-MADE
34SBAPD8771
01/30/2017
01/30/2018
DIED X I RETENTION $ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
QFFICER/MEMBER EXCLUDE[
(Mandatoryb NH)
If es, describe under
DESCRIPTION OF OPERATIONS below
N/A
4077567
02/01/2017
02/011Z018
PER OTH-
T
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
1,000,000
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: General Consulting Services. P1044 Consulting Engineering Services W. Orchard Pond and Storm Drainage Project and Future Stormwater Facilities
Minor Capital Improvements.
.111 IVM 1 L IIVLVLR GANGtLLA I ION
City of Fort Collins Purchasing Department
215 N Mason St 2nd Floor
Fort Collins, CO 80522
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
v%.VI[V ID [4V IO/U3)
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