HomeMy WebLinkAboutCAROLLO ENGINEERS - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID
CAROL10
DATE(MMIDDIYYYY)
12 01 06
PRODUCHi
Brown & Brown Insurance of AZ
2800 N. Central Ave., #1600
P.O. Box 2800
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Phoenix AZ 85002-2800
Phone: 602-277-6672
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Travelers Prop/Cas of America
0532
INSURER B: Charter Oak Fire
25615
Carollo Engineers P.C.
Risk Management Offi e
3033 N 44th Street, #101
Phoenix AZ 85018
INSURERC: Great American Insurance Co.
0255
INSURERD: Farmington Casualty Co.
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
P LICY EFFECTIVE
DATE MMIDD
POLICYEXPIRATION
DATE MMIDDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1000000
PREMISES Ea occurence
$ 500000
A
X
COMMERCIAL GENERAL LIABILITY
630188B39406
12/31/06
12/31/07
CLAIMS MADE j]OCCUR
]X!
MED EXP(Any one person)
$20000
PERSONAL & ADV INJURY
$ 1000000
Contractual Liab
EXCLUDING PROF LIAB
GENERAL AGGREGATE
$ 10000000
(SEPERATE POI)
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2000000
X POLICY PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
810995K500806
12/31/06
12/31/07
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
X
BODILY INJURY
(Per person)
$
B
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
PLCAP995K500806
`TI'J"��q•v
IIC[ Irya
,l.L\]J30
—
������444[[[lll��..44
'I Iffy'
LL.SY4WWGrr�
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
.
�o
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
CITY
RISK
F FORT COLLINS
MANAGEMENT
LINS
OTHER THAN EAACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 1000000
C
X I OCCUR CLAIMS MADE
TUU5595799
12/31/06
12/31/07
AGGREGATE
$ 1000000
Excess of
$
Automobil
$
DEDUCTIBLE
X RETENTION $10000
Work Com
$
A
D
WORKERS COMPENSATION AND
EMPLOYERS'LIASILITY
ANY PROPRIETORIPARTNERIEXECUTNE
OFFICER'MEMBER EXCLUDED?
If es, describe under
SPECIAL PROVISIONS below
PACRUB995K342106
FARHINGTONtCALIFORNIA)
12/31/06
12/31/07
X TORY LIMITS I I ER
E.L. EACH ACCIDENT
$ 1000000
--
E.L. DISEASE - EA EMPLOYE
—
$ 1000000
E.L. DISEASE -POLICY LIMIT
$ 1000000
OTHER
ADDITIONAL INSURED DOES
NOT APPLY TO WORK COMP
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*Except for 10 Days for Non -Payment of Premium; Except for the Workers
Compensation coverage. Re: P972 On Call Professional Electric &
Instrumentation Engineering Svcs, Carollo Project No: 7094A.10
City of Fort Collins, its officers and employees are named as additional
insured as respects to the General Liability per form CGD251(01/03).
U itKI Ir IUA I C KULL/CK CAN[:F[ I AIIUN
CITYFO3
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL � MAIL 30 * DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City
of Fort Collins, Colorado
Attn:
James B. O'Neill
A 1Z D�PRE,SE VE
215 N. Mason St., 2nd Floor
Fort Collins CO 80522-0580
#%L'unu LJ (LUU IIUD) 9 AGORD GORPORATION 1938
Carollo Engineers, P.C.
Policy No.: 6300188B39406
Effective: 12/31/06 to 12/31/07
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY — CONTRACTORS COVERAGE PART
1. WHO IS AN INSURED — (Section II) is amended
to include any person or organization you are re-
quired to include as an additional insured on this
policy by a written contract or written agreement
in effect during this policy period and signed and
executed by you prior to the loss for which cover-
age is sought. The person or organization does
not qualify as an additional insured with respect to
the independent acts or omissions of such person
or organization. The person or organization is
only an additional insured with respect to liability
caused by "your work" for that additional insured.
2. The insurance provided to the additional insured
is limited as follows:
a) In the event that the limits of liability stated in
the policy exceed the limits of liability required
by a written contract or written agreement in
effect during this policy period and signed and
executed by you prior to the loss for which
coverage is sought, the insurance provided
by this endorsement shall be limited to the
limits of liability required by such contract or
agreement. This endorsement shall not in-
crease the limits stated in Section III — LIMITS
OF INSURANCE.
b) The insurance provided to the additional in-
sured does not apply to "bodily injury", "prop-
erty damage", "personal injury" or "advertising
injury" arising out of an architect's, engineer's
or surveyor's rendering of or failure to render
any professional services including:
I. The preparing, approving or failing to
prepare or approve maps, shop drawings,
opinions, reports, surveys, field orders,
change orders, or drawings and specifi-
cations; and
11. Supervisory or inspection activities per-
formed as part of any related architectural
or engineering activities.
c) This insurance does not apply to "bodily in-
jury" or "property damage" caused by "your
work" included in the "products -completed
operations hazard" unless you are required to
provide such coverage for the additional in-
sured by a written contract or written agree-
ment in effect during this policy period and
signed and executed by you prior to the loss
for which coverage is sought and then only
for the period of time required by such con-
tract or agreement and in no event beyond
the expiration date of the policy.
d) This insurance does not apply to any person
or organization for whom you have procured
separate liability insurance while such insur-
ance is in effect, regardless of whether the
scope or limits of insurance in this policy ex-
ceed those of such other insurance or
whether such other insurance is valid or col-
lectable.
3. Subpart (1)(a) of the Pollution exclusion under
Paragraph 2., Exclusions of Bodily Injury and
Property Damage Liability Coverage (Section I —
Coverages) does not apply to you if the "bodily
injury" or "property damage" arises out of "your
work" performed on premises which are owned or
rented by the additional insured at the time "your
work" is performed.
4. Any coverage provided by this endorsement to an
additional insured shall be excess over any other
valid and collectible insurance available to the
additional insured whether primary, excess, con-
tingent or on any other basis.
S. As a condition of coverage, each additional
insured must:
a.) Give us prompt written notice of any "occur-
rence" or offense which may result in a claim
and prompt written notice of "suit".
b.) Immediately forward all legal papers to us,
cooperate in the investigation or settlement of
CG D2 51 0103 Copyright, The Travelers Indemnity Company, 2003 Page 1 of 2
COMMERCIAL GENERAL LIABILITY
the claim or defense against the "suit," and
otherwise comply with policy conditions.
c.) Tender the defense and indemnity of any
claim or "suit" to any other insurer which also
insures against a loss we cover under this
endorsement. This includes, but is not limited
to, any insurer which has issued a policy of
insurance in which the additional insured
qualifies as an insured. For purposes of this
requirement, the term "insures against" refers
to any self-insurance and to any insurer which
issued a policy of insurance that may provide
coverage for the loss, regardless of whether
the additional insured has actually requested
that the insurer provide the additional insured
with a defense and/or indemnity under that
policy of insurance.
d.) Agree to make available any other insurance
that the additional insured has for a loss we
cover under this endorsement.
Page 2 of 2 Copyright, The Travelers Indemnity Company, 2003 CG D2 51 01 03