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AECOM EDAW - INSURANCE CERTIFICATE
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 4/1/2010 DATE (MM/DD/YYYY) 4/1/2009 PRODUCER Lockton Insurance Brokers, LLC 19800 MacArthur Blvd., Suite 550 CA License #01715767 Irvine 92612 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. 949-252-4400 INSURERS AFFORDING COVERAGE NAIC # INSURED AECOM Technology Corporation INSURER A : Travelers Property Casualty Company of America 25674 INSURER B : 1075642 EDAW, Inc. a Delaware Corporation 240 E. Mountain Avenue Fort Collins CO 80524-2821 INSURER C : INSURER D : INSURER E : COVERAGES AECTE01 OF THIS GERTIFIGATE OF INSURANCE OOES NOT CONS I I I U I E A CON I KAC I BETWEEN WEEN THE ISSUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. 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 LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ XXXXXXX DAMAGE TO RENTED .PREMISES Ea-occurence— -$- - XXXXXXX COMMERCIAL GENERAL. LIABILITY_ - . _ - - -_ - .-... CLAIMS MADE F—TOCCUR _ _ _ NOT APPLICABLE _ _ _ MED EXP (Any one person) $ YY%, X PERSONAL & ADV INJURY $ XXXXY—XX GENERAL AGGREGATE $ XXXXXX-X GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ XXXXXXX PRO - ri POLICY JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ XXXXXXX BODILY INJURY (Per person) $ XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS NOT APPLICABLE BODILY INJURY (Per accident) $ XX)CXXXX HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ XXX�� GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XYXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ XXX)CXXX OCCUR CLAIMS MADE AGGREGATE $ XXX)CXXX $ XXXXXXX UMBRELLA NOT APPLICABLE $ XXXXXXX DEDUCTIBLE FORM $ XXXXY—XX RETENTION $ A - -- - -WORKERS COMPENSATION AND _ _. TRJUBA245B231-TIL-09 _ 4/1/2009 _ - 4/1/2010 X WC STATU- OTH- TORY LIMITS ER A A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (AZ,MA,OR,Wo TC2JUB-4245B22A-TIL-09 4/1/2009 4/1/2009 4/1/2010 4/1/2010 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 A byes, a under SPECIALAL PROVISIONS below No PRE.L. (All States) Other 4/1/2009 4/l/2010 DISEASE -POLICY LIMIT $ 1.,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: PROJECT #04030071.01 / OLD TOWN SQUARE PLAZA RENOVATIONS P-957. A Waiver of Subrogation is afforded to the certificate holder where required by written contract. See attached Waiver of Subrogation endorsement. 1V11 VV4/1 2831300 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn: John Stephen, Cppo/Senior Buyer NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL P.O. BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins, CO 80522-058 REPRESENTATIVES. AUTHORIZED REPRES I ACORD 25 (2001/081 For questions regarding this certificate, contact the number listed in the 'Producer' section above ands city the cii coe AECTEo1'. © ACORD CORPORATION 1988 TRAVELERS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00) POLICY NUMBER: TC2JUB-4245B22A-TIL-09 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or-indirecly-to-benefit anyone not -named in -the -Schedule. -- - SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER Miscellaneous Attachment: M100471 Certificate ID : 2831300