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Home My WebLink AboutCAROLLO ENGINEERING - INSURANCE CERTIFICATE10/16/OBgrE (mM/DOnv) ACORD„ CERTIFICATE OF LIABILITY INSURANCE D PRODUCER 0641361 1-949-729-0777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hilb Regal & Hobbs Professional Practice Insurance Brokers, Inc. 2030 Main Street Suite 350 Irvine, CA 92614 ONLY Al HOLDER. ALTER TI Sandi Moreno INSURED Carollo Engineers P.C. _INSURER A: AC Risk Management Office INSURER B: 10540 TALBERT AVENUE, SUITE 200 EAST INSURER C: FOUNTAIN VALLEY, CA 92708 INSURER D__ COVERAGES THE CERTIFICATE INSURERS AFFORDING COVERAGE 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. IN . TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ _ 7 CLAIMS MADE u OCCUR LED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PFnTRO LOC _AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ . NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) I GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHEEAACC $ ._._ AUTO ONLY AUTO ONLY: qGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR _ CLAIMS MADE AGGREGATE $ -�—-- $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH TQRY_LIMITS Eft_ EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT S OTHER A Professional Liability G21656495005 07/04/08 07/04/09 Per Claim $5,000,000 Retroactive Date: Unlimited Aggregate $5,000,000 Deductible s400,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Renewal, P972 On Call Professional Electrical and Instrumental Engineering Carollo Project #: Not yet assigned. V GR11!-R,MIC IIVLYGRI I XUUII WNAL 1NbUHtU: IN.I'UHCH LG I I GH: IMPIR,CLL IIUNV U Lays MOLICe r0I NOR -Payment OL YIenlum SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION FPc.- y of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL 6MX9Wf4 MAIL 30 OAYS WRITTEN chasing Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BIW76741LmIQ0'E076'AX9FMYHX P.O. Box 580 Fort Collins, CO 80522-0580 USA AUTHORIZED REPRESENTATIVE DebbieR C 1988 ACORO CERTIFICATE OF LIABILITY INSURANCE OP ID B DATE (MM DD YYYY) CAROL10 10 16 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown 8 Brown Insurance of AZ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2800 N. Central Ave., #1600 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 INSURER A: Traveler. Pmrw casualty co 0532 INSURERS: Groat American Inauranc Co. 0255 Carollo Engineers P.C. �INSURER C: Charter Oak Fir e 25615 Risk lonEn4ginee Officpp 3033 N. 44th Street, #SO1 ( INSURER O: Phoenix AZ 85018 _ 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, LTIi NSRp TYPE OF INSURANCE POLICY NUMBER DATE M�M/DD DATE MMID LIMITS GENERAL LIABILITY EACH OCCURRENCE ' $1000000 A X X COMMERCIAL GENERAL CLAIMS MADE IX.j OCCUR 6300188B394TIL07 12/31/07 12/31/08 PREMISEs(eaoaurence s500000 MED EXP(My one person) $20000 X Contractual Li.ab MnSSIGRAL LIRE EXCL PERSONAL& ADV INJURY $ 1000000 SEPARATE POLICY GENERAL AGGREGATE $ 10000000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 71 JEC t LOG PRODUCTS COMP/OP AGO $2000000 A AUTOMOBILE LIABILITY ANY AUTO 810995KS008TIL07 12/31/07 '. 12/31/08 COMBINED SINGLE LIMIT (Ea accident) �$lOOOOOO X C ALL OWNED AUTOS SCHEDULED AUTOS BA995K500807CAG TX 12/31/07 12/31/08 ',, BODILY INJURY (Per person) $ MIRED AUTOS NONOWNED AUTOS X BODILY INJURY (Per ec d%t) $ X PROPERTY DAMAGE (Per accident) $ --- ------ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $_ ANY AUTO OTHERTHAN -EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE L$ 1000000 B X OCCUR CLAIMS MADE TM5595799 12/31/07 12/31/08 AGGREGATE $ iQOQQOQ DEDUCTIBLE X RETENTION $ Q $ WOEMPLOYERS' LIABILITY RKERS COMPENSATION AND - A ANY PROPRIETOR/PARTNERIFXECUTIVE OFFICERIMEMBER EXCLUDED? . WeWe. deaaibe under PROVISIONS below PFUB995K342107 12/31/07 12/31/08 X TORYLIMITS ER E.L. EACH ACCIDENT $1000000 E.L. DISEASE • EA EMPLOYEE( $ 1000000 E.L. DISEASE -POLICY LIMIT 1 $1000000 OTHER ADDITIONAL INSURED OGEE NOT APPLY TO RORi( COMP DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *Except for 10 days notice for nonpayment of premium, except Workers Comp. RE: Renewal, P972 On Call Professional Electrical and Instrumental Engineering Services. Carollo Project No.: Not yet assigned. The City of Fort Collins is Additional Insured on the General Liability per form #CGD248(08/05). City of Fort Collins Purchasing Division PO Box 580 Fort Collins CO 80522-0580 FORTC01 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WLLLS�MAIL 30* DAYSWRTREN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, omw 25 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. AGOKU Z5 (ZUU7/U13) Policy Number: 630-OIBM94-TIL-07 Campo Engineers, P.C. 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 1. 03 WHO iS AN INSURED — (Section 11) 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 Pert, but: a) Only with respect to Nobility for °bodily injury", "property damage" or *personal injury"; and b) If, and only to the extent that, Via 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 qualify 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 Limhits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance', the irf sumnce provided to the additional insured shall be limited to the limits of Natality, re- quired by that "written contract requiring in- surance". This endorsement shop not in- crease the limits of insurance des iibed 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 services, including: I. The preparing, approving, or failing to Prepare or approve, maps, shop draw. ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove. drawings and speddticatorhs: and ii. Supervisory, 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' unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional Insured, and Oren the insurance provided to the additional insured applies only to such "bodily 1*ry" or "property damage" that oc- ars before the end of the period of time for Which the "written contract requiring insu - one requires you to provide such coverage or the end of the policy period, whichever Is earlier. 3. The Insurance provided to the additional insured by This endorsement is excess over any valid and collectible "other hlsurenca", whether primary, excess, contingent or on any other basis, that is available b the additional insured for a loss we cover under this endorsement. However, if the 'written contract requiring insurance" specifically requires that this insurance apply on a primary ft� or Primary and non-contributory basis, 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 "outer 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 dondikn of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written noticee as soon as practicable of an *occur- rence" or an offense which may result in a 011firrL To the extent possible, such notice should Include. CG D2 46 08 05 0 2005 The SL Paul Travelers Companies, Inc. Page t of 2 COMMERCIAL GENERAL LIABILITY I. How. when and where the "occurrence" or offense took place; If. The names and addresses of any injured persons and witnesses: and fit. The nature and location of any injury or damage arising out of the "occurrence` or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: f. Immediately record the specfics of the claim or'suit" and the dale received; and IL Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or *suit' as soon as practicable. c) The additional 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 or defense against the "suit", and otherwise comply with all policy conditiors. d) 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 motion does not affect whether the Insur- ance provided to the additional Insured by this endorsement is primary to "other 'awur- ance' available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. S. The following definition Is added to SECTION V. — DEFINITIONS: 'Written contract requiring insurance' nears that part of arty written contract or agreement under which you are required to include a person or organization as an additional ln- surad on this Coverage Part, provided that the *WHY 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. While that part of the contract or agreement Is in effect; and C. Before the end of the policy period Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05