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HomeMy WebLinkAbout130088 ICON ENGINEERING INC - INSURANCE CERTIFICATE (36)ICONENG-01 DAWNG ACORO DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 06/23/2017 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 5660 Greenwood Plaza Blvd. (A/C, No, Ext): (303) 799-0110 FAX , No): (303) 799-0156 Suite 500 1Ep IIL : BethF@thinkccig.com Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC # INSURED ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 INSURERA:The Hartford Insurar INSURER B : Plnnacol Assurance INSURER E : INSURER F : nnVFRAnPR rFRTIGirATF NI IRARI=P• PF=%/1CInKl KlHRAPr-0- 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR fDDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 34SBAPD8771 01/30/2017 01/30/2018 EACH OCCURRENCE $ 2,000,000 GTO RENTED S(Eaoccunce $ 300,000 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ LOC JECT OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS 4,000,000 $ $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X 34SBAPD8771 01/30/2017 01/30/2018 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE 34SBAPD8771 01/30/2017 01/30/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROP RIETOR/PARTNER/EXECUTIVE Y/N FFICER/MEMBER EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 407756W7 02/01/2017 02/01/2018 PER OTH- STAT T R 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) RE: 8497 Stormwater Consulting Engineering Services As required by written contract, The City, its officers, agents and employees shall be named as additional insureds on the General Liability and Automobile Liability insurance policies for any claims arising out of worked performed under this Agreement. L:tK I It-JUA I t HULUtK (;ANt:tLLA I IUN City of Fort Collins 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