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HomeMy WebLinkAboutCAROLLO ENGINEERS - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID B 1 DATE IMMlDD/YYYY) CAROL10 12 13 07 PRODUCER Brown & Brown Insurance of AZ 2800 N. Central Ave. , #1I600 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 P.O. Box 2800 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Phoenix AZ 85002-2800 Phone: 602-277-6672 INSURERS AFFORDING COVERAGE NAIC # INSURED - - - INSURERA Travelers Property Casualty Co D532 - INSURER B Great Ar,erucan Insurance Co 0255 ' Carollo Engineers P.C. - Risk Management Office 10540 Tal5ert Ave. , Ste 200 E Fountain Valley CA 92708 INSURER Charter Oak Fire _ 25615 INSURER -- — — ---- 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 OFJANY 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 -' IRSR LTR WDD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIYY POLICY EXPIRATION` DATE MM/DD/YY --- LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X — I X COMMERCIAL GENERAL LIABILIITY 630018813394TIL07 12/31/07 12/31/08 -DAMAGE TO -RENTED — PREMISES Eaoccurence $500000 CLAIMS MADE 1 " OCCUR MED EXP (Any one person) _ $ 20000 X I Contractual Liab PROFESSIONAL LIAR EXCL $ 1000000 PERSONAL 8 ADV INJURY SEPARATE POLICY GENERAL AGGREGATE $ 10000000 GOTL AGGREGATE LIMIT APPLIES PER _ PRODUCTS -COMPIOPAGG $2000000 IX l POLICY jE O I7 LOC AUTOMOBILE LIABILITY A X ANY AUTO 810995K5008TIL07 12/31/07 12/31/08 COMBINED idt) SINGLE LIMIT $ 1000000 (Eaacaden, C ALLOWNEDAUTOS BA995K500807CAG TX 12/31/07 12/31/08 - BODILY $ SCHEDULEDAUTOS (Per person) X HIRED AUTOS --- ---I BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) j I- - II - - --- -- - ---- --- - PROPERTY DAMAGE $ (Per accident) ' GARAGE LIABILITY AUTO ONLY _EA ACCIDENT $ ANYAUTO OTHER THAN EA ACC $ AUTO ONLY AGO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 B ��I!X OCCUR CLAIMS MADE TUU5595799 12/31/07 12/31/08 AGGREGATE '$ 1000000 $ DEDUCTIBLE $ jX RETENTION $ O �— � $ -- WORKERS COMPENSATION AND IAI X WC STATU- OTH- TORYLIMITS iI ER I___- A EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVL= PFUB995K342107 12/31/07 I 12/31/0$ __ EL EACH DENT $ 1000000 OFFICERIMEMBER EXCLUDED' j _ _ _ E L DISEASE - EA EMPLOYEE$ 1000000 If yes descnbe under I- -- - SPECIALPROVISIONSbelow EL DISEASE -POLICY LIMIT $ 1000000 OTHER ADDITIONAL INSURED DOES NOT APPLY TO NORR CQHp DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *Except for 10 Days forl Non -Payment of Premium; Except for the Workers Compensation coverage. IRe: 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 with respects to General Liability per form CGD248 (08/05). C ITYFO3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL IMMMMO TO MAIL 30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Fort Collins, Colorado Attn: James B. O'Neill 215 N. Mason Sty, 2nd Floor AU;ZED REP rnTIVe/J Fort Collins C0180522-0580 d/, ACORD 25 (2001/08) 0 ACORD CORPORATION 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 ACORD 25 Policy Number 630-0188B394-TIL-07 Camillo Engineers, P G COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (CONTRACTORS OPERATIONS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART t. FA WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but a) Only with respect to liability for "bodily injury", "property damage" or 'personal Injuryand b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work' to which the "written contract requiring insurance' applies The person or organization does not quaky as an additional Insured with respect to the independent acts or omissions of such person or organization The insurance provided to the additional insured by this endorsement is limited as follows a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the `written contract requiring insurance', the in- surance provided to the additional insured shall be limited to the limits of hablhty re- quired by that "written contract requiring m- surance"- 1 his endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance b) The insurance provided to the additional in- sured does not apply to "bodily injury', "prop- erty damage} or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying seances, including i. The preparing, approving, or fading to prepare or approve, maps, shop draw - rugs, opinions, reports, surveys field or- ders or change orders, or the preparing, approving, or fading to prepare or ap- prove, drawings and specifications, and n Superm,.ory, inspection, architectural or engineering activities c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage' caused by "your work" and included in the "products -completed op- erations hazard" 3 The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance', whether primary, excess, contingent or on any other basis, that is available to the additional insured for a fuss we cover under this endorsement However, if the 'wntten contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance' But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible 'other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance" 4 As a condition of coverage provided to the additional insured by this endorsement a) The additional insured must give us written notice as soon as practicable of an 'occur- rence" or an offense mrhich may result in a claim To the extent possible such notice should include r Ilow, when and where the 'occurrence" or offense took place u The names and addresses of any injured persons and witnesses, and ue The nature and location of any injury or damage arising out of the "occurrence" or offense CG D2 48 08 05 OO 2005 The St Paul Travelers Companies, Inc Page 1 o1 2 COMMERCIAL GENERAL LIABILITY b) c) d) If a claim is made or "suit" is brought against the additional insured, the additional insured must r. Immediately record the specifics of the claim or I'surt" and the date received, and H, Notify us as soon as practicable The addtrcnal insured must see to it that we receive written notice of the claim or "snit" as soon as practicable The addtronal insured must immediately send us copies of all legal papers received in connection with the claim or "suit*, cooperate with us in the investigation or settlement of the claim on defense against the "suit and otherwise comply with all policy conditions The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement Is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3 above 5 The following definition is added to SECTION V — DEFINITIONS "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed a After the signing and execution of the contract or agreement by you, b White that part of the contract or agreement is in effect, and c. Before the end of the policy period Page 2 of 2 © 2005 The St Paul Travelers Companies, Inc CG D2 48 08 05