HomeMy WebLinkAboutURS - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE page 1 of 2
DATE
04/29/2007
PRODUCER 877-945-7378
Willie North America, Inc.
26 Century Blvd.
P. O. Box 305191
Nashville, TN 372305191
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.
INSURERS AFFORDING COVERAGE
NAIL#
INSURED URS Corporation
600 Montgomery Street, 25th Floor
San Francisco, CA 94111
INSURERA: National Union Fire Ins Cc of Pittsburgh
19445-100
INSURERB. American International South Insurance Cc
40258-001
INSURER C: Insurance Company of the State of PA
19429-100
INSURER D. Lloyd' s of London/A.F. Beazley Syndicate
15792-200
INSURERE: Lexington Insurance Company
19437-000
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.
INSR DD'
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATIONIMSR
LIMBS
A
GENERAL LIABILITY
GL197-9807
5/l/2007
5/l/2008
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X❑ OCCUR
PREMISES Eeoccurence
$ 11000,000
MEDEXP(Anyoneperson)
$ 10,000
PERSONAL& ADV INJURY
$ 1,000,000
X XCU, BFPD
X Contractual Liability
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
7 POLICY X PRO LOC
A
A
AUTOMOBILE
LIABILITY
ANY AUTO
CAS26-2672
CA826-2675
5/1/2007
5/1/2007
5/1/2008
5/l/2008
COMBINED SINGLE LIMIT
(Eaaccident)
$ 2,000�OOO
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Peraccident)
$
HIREDAUTOS
NON-OWNEDAUTOS
PROPERTY DAMAGE
(Per accident)
$
GAR AGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EAACC
$
7ANYAUTO
$
17
AUTO ONLY: AGG
EXCESS LIABILITY
EACHOCCURRENCE
$
OCCUR CLAIMSMAOE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
WC7181903
l/l/2007
1/1/2008
STAT
X I wRYLIMI
E.L. EACH ACCIDENT
$ 1,000,000
B
ANY PROPRIETOR/PARTNER/EXECUTIVE
WC7181935
1/l/2007
1/1/2008
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
L,
C
OFFICERIMEMBEREXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
WC7181937
WC718190¢ WC7181936
l/1/2007
1
1/1/2008
1/1/2008
E.L. DISEASE - POLICY LIMIT
$ 11000,000
D
OTHER
MMP 0005
5 1 2007
NNE
5 1 2008
E
Professional Liability
1156494 E&O
5/1/2007
5/1/2008
$1,000,000. Each Claim
w/Limited Contractual -
$1,000,000. Aggregate
Claims Made Policy
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES(EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Project No.: 22236040 - Dry Creek Basin Flood Control Project
CERTIFICATE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Fort Collins I NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Opal Dick I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
215 North 2nd Floor Mason Street REPRESENTATIVES.
P.O. BOX 580 U RIZEDREPRESEyRATIVE I \
Fort Collins, CO 80522-0580 � ti YlA
D25(2001/08) Coll:1967856 Tpl:627065 Cert:88V1425 OACORDIkORPORATION1988
Page 2 of 2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
25(2001/081 Collu1967A56 Pn1c627065 rAvt-AA91425