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HomeMy WebLinkAboutTETRA TECH INC - INSURANCE CERTIFICATE® 'A`0%20CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/28/2009 PRODUCER Aon Risk Insurance services West, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Los Angeles CA office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 707 Wilshire Boulevard CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Suite 2600 COVERAGE AFFORDED BY THE POLICIES BELOW. Los Angeles CA 90017-0460 USA INSURERS AFFORDING COVERAGE NAIC# PHONE• 866 283-7122 FAx- 847 953-5390 INSURED INSURER A: American International specialty Lines 26883 •• Tetra Tech, Inc. I."~, INsuRERB: Insurance Company of the State of PA 19429 1576 Sherman St., Suite 100 INSURERC: National union Fire Ins Co of Pittsburgh 19445 Denver CO 80203 USA INSURERD: Lexington insurance Company 19437 ' - INSURER E: O OVERAGF.0 SIR applies per terms and conditions of the policv 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. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INSRU TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ATE MM/DD DATE MM/DD CJjENERALLIABILITY GL4376193 10/01/2009 10/01/2010 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100 , 000 CLAIMS MADE ® OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY $1, 000 000 ❑ , GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S2,000,000 ❑ POLICY El PRO- LOC JECT C AUTOMOBILE LIABILITY CA 826 33 86 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 2 , 000 , 000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS - ( Per. person) X HIRED AUTOS BODILY INJURY- X NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT AUTO OTHER THAN EA ACC HANY AUTO ONLY : AGG D EXCESS / UMBRELLA LIABILITY TH0900029 10/01/2009 10 01 2010 EACH OCCURRENCE , , ElOCCUR ❑ CLAIMS MADE AGGREGATE $5,000,000 - ®DEDUCTIBLE RETENTION $100,000 B B WORKERS COMPENSATION AND Y N EMPLOYERS'LIABILITY WC wC6987927 10/01/2009 10/01/2010 X WC STATU- T RY LIMIT OTH- E.L. EACH ACCIDENT $1, 000, 000 ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. DISEASE -EA EMPLOYEE S1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -POLICY LIMIT $1, 000, 000 if es, describe under SPECIAL PROVISIONS below A OTHER Contractor Prof COPs1952583 10/01/2009 1 1 Each claim $5,000,000 Deductible $250,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Stop Gap Coverage for the following states: OH, WA, WY. f FRTi ITTr A TF 14n1 IIFR r A N!`Fi 7 A TInN City of Ft. Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: Opal Dick DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL PO BOX 580 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, , Fort Collins Co 80522 -0580 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 1_qL �� fYaat✓fwn ACORD 25 (2009/01) (01988-2009 ACORD CORPORATION. All rights reserve Tl.n Arnun ..­ ..A I,.r.,. — .a..:.r­a m V. of AVn0rl O z d v Q U INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver Co 80203 USA 100983 (2/09) page 6 of 11 No person or organization, other than you, is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named insured in the Declarations. Coverage under this policy, however, will not apply: a. Prior to the termination date of any joint venture, partnership or limited liability company; or b. If there is valid and collectible insurance purchased specifically to insure the partnership, joint venture or limited liability company. V. SUPPLEMENTARY PAYMENTS Under SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A AND B , Paragraph 1.b , is deleted in its entirety and replaced with the following: b. up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily injury Liability Coverage applies. we do not have to furnish these bonds. VI. LIBERALIZATION CLAUSE If we revise or replace our standard policy form to provide more coverage, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. VII. UNINTENTIONAL ERRORS AND OMISSIONS SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. - Representations is amended by adding: d. The unintentional failure by you or any insured to provide accurate and complete nonmaterial representations as of the inception of the policy will not prejudice the coverages afforded by this policy. VIII. AMENDMENT OF DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 2. - Duties in the Event of Occurrence, offense, claim or suit, a. is hereby deleted and replaced with the following: a. You must see to it that we are notified as soon as practicable of any "occurrence" 100983 (2/09) Page 6 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 7 of 11 B. or an offense, which may result in a claim. Knowledge of an "occurrence" or an offense by your agent your servant, or your employee will not in itself constitute knowledge to you unless the Director of Risk Management (or one with similar or equivalent title) or his/her designee will have received such notice. To the extent possible notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. IX. AMENDMENT OF EXPECTED OR INTENDED INJURY EXCLUSION SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY , 2. - Exclusions, a. - Expected or intended Injury , is deleted and replaced by the following: a " Bodily injury " or " property damage expected or intended from the standpoint of the insured. This exclusion does not apply to " bodily injury " or " property damage " resulting from the use of reasonable force to protect persons or property. x. CONTRACTUAL LIABILITY - RAILROADS Only with respect to (i) operations performed within 50 feet of railroad property and (ii) for which a Railroad Protective Liability Policy in the name of the railroad has been provided, then A. SECTION V - DEFINITIONS, Paragraph 9, is deleted in its entirety and replaced with the following: 9. 1.insured Contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; C. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; 100983 (2/09) Page 7 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 8 of 11 e. An elevator maintenance agreement; f. That part of any other contractor agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which xou assume the tort liability of another party to pay for "bodily injury or "property damage' to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities; and B. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. - Other Insurance, b. Excess insurance, (1) (a) , is amended to include the following: (v) That is a Railroad Protective Insurance Policy or similar coverage. XI. COVERAGE FOR YOUR SUPERVISORY OR MANAGERIAL EMPLOYEES RELATING TO CO -EMPLOYEE INJURIES SECTION II - WHO IS AN INSURED, 2.a. (1), (a) and (b) are clarified to hold that: Your supervisory or managerial " employees " are insureds for " bodily injury " to " co - employees " while in the course of their employment or performing duties related to the conduct of your business if claims or suits arise out of liability assumed by an insured 100983 (2/09) Page 8 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver Co 80203 USA 100983 (2/09) page 9 of 11 under an " insured contract " as provided by SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, e. Employer ' S Liability. XII. WAIVER OF TRANSFER OF RIGHTS OR RECOVERY AGAINST OTHERS TO US SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. - Transfer Of Rights of Recovery Against others To US, is amended by the addition of the following: we waive any right of recovery we may have against any person or organization pursuant to applicable written contract or agreement you enter into because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". XIII. AMENDMENT OF OTHER INSURANCE A SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4.- Other Insurance, b. - Excess Insurance, (1), is amended to include the following: This insurance shall not be excess where (i) such other insurance is specifically purchased to apply as excess of this policy, or (ii) where you are obligated by contract to provide primary insurance to an additional insured, unless there is other additional insurance coverage available to that additional insured. B SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4.- Other Insurance, b. - Excess Insurance, (2), is deleted in.its entirety and replaced with the following: when this insurance is excess, we will have no duty under coverages A or B to defend any claim or "suit" that any other insurer has a duty to defend. If no other 100983 (2/09) Page 9 Certificate No : 570036285283 I.NSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 10 of 11 insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. XIV. AMENDMENT AGGREGATE LIMITS PER PROJECT A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I ), offense under COVERAGE B (SECTION 1) and for all medical expenses caused by accidents under COVERAGE C (SECTION I ), which can be attributed only to ongoing operations at a single designated construction project: 1. A separate Per Construction Project General Aggregate Limit appies to each construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Per Construction Project General Aggregate Limit is the most we will pay for the sum of (i) all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products-completj ed operations hazard", (ii) al damages under COVERAGE B and (iii) all medical expenses under COVERAGE C regardless of the number of: a. Insureds; b. claims made or "suits" broMt; or C. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A or B for damages or under COVERAGE C for medical expenses shall reduce the Per Construction Project General Aggregate Limit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Per Construction Project General Aggregate Limit for any other construction project covered under this policy. 4. The limits shown in the Declarations for Each occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Per Construction Project General Aggregate Limit. 100983 (2/09) Page 10 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 11 of 11 Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION I ), offenses under COVERAGE B (SECTION 1) and for all medical expenses caused by accidents under COVERAGE C (SECTION I ), which cannot be attributed only to ongoing operations at a single construction project: 1 . Any payments made under COVERAGE A or B for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Construction Project General Aggregate Limit. C. when coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the construction Project General Aggregate Limit. D. if the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits of Insurance (SECTION III ) not otherwise modified by this endorsement shall continue to apply as stipulated. 100983 (2/09) Page 11 Certificate No : 570036285283 ACO ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ��- 09/28/2009 PRODUCERonRisk Insurance Services West, Inc. ATHIS on CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY LOS Angeles CA office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 707 wi 1 shire Boulevard CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Suite 2600 COVERAGE AFFORDED BY THE POLICIES BELOW. Los Angeles CA 90017-0460 USA PHONE- 866 283-7122 FAX- 847 953-5390 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: American International Specialty Lines 26883 •• Tetra Tech, Inc. 19429 w07- INSURERB: Insurance Company of the State of PA 1576 Sherman St., Suite 100 INSURERC: National union Fire Ins Co of Pittsburgh Denver CO 80203 USA 19445 INSURER D: Lexington Insurance Company 19437 b • INSURER E: p COVERAGES SIR applies per terms and conditions of the policy 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. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INSRU TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ATE MM/DD DATE MM/DD/YYYY C ERAL LIABILITY GL4376193 10/01/2009 10/01/2010 EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100 , 000 CLAIMS MADE M OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) $5,000, O PERSONAL & ADV INJURY $1, 000 , 000 N O GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: N to PRODUCTS - COMP/OP AGG S2,000,000 POLICY X PRO- JECT LOC m O O^ Ln c AUTOMOBILE LIABILITY X ANY AUTO CA 826 33 86 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT (Ea accident) $ 2 , 000 , 000 p Z d BODILY INJURY ( Per person) ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS _ +' w V BODILY INJURY X NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 1H ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG D EXCESS / UMBRELLA LIABILITY TH0900029 10/01/2009 10/01/2010 EACH OCCURRENCE $5,000, OCCUR ❑ CLAIMS MADE AGGREGATE -- $5,000,000 _ DEDUCTIBLE - - RETENTION $100,000 B B WORKERS COMPENSATION ANDwc6987927 EMPLOYERS' LL4BILITY N wC 7 1 10/01/2009 10/01/2010 X WC STATU- IMIT OTH- ER E.L. EACH ACCIDENT $1, 000, O00 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -POLICY LIMIT $1 , 000 , 000 if es, describe under SPECIAL PROVISIONS below A OTHER COPS1952583 10/Ol/2009 10 10112010 Each claim $5,000,000 Contractor Prof Deductible $250,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Stop Gap Coverage for the following states: OH, WA, WY. CERTIFICATE HOLDER CANCELLATION City of Ft. Collins Attn : opal Dick SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL PO BOX 580 - 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fort Collins CO 80522-0580 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �ym 6�✓f+�rcfa c.7sLsgo,D � ACORD 25 (2009/01) The ACORD name and logo are 01988-2009 ACORD CORPORATION. All rights reserved registered marks of ACORD Aco aCERTIFICATE OF LIABILITY INSURANCE DATE09/29/2009 PRODUCER Aon Risk insurance Services west, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Los Angeles CA Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 707 wi 1 shire Boulevard CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Suite 2600 COVERAGE AFFORDED BY THE POLICIES BELOW. Los Angeles CA 90017-0460 USA INSURERS AFFORDING COVERAGE NAIC # w PHONE- 866 283-7122 FAX 847 953-5390 INSURED INSURERA: American International specialty Lines 26883 Tetra Tech RMC Inc. 19429 rr67-. INSURERB: Insurance Company of the State of PA 1576 Sherman St., Suite 100 INSURER C: National union Fire Ins Co of Pittsburgh Denver Co 80203 USA 19445 INSURERD: Lexington Insurance Company 19437 b INSURER E: COVERAGES SIR applies per terms and conditions of the policy "" 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. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS ATE(MM/DD DATE(MM/DD/YYYY C ENERALLIABILITY GL4376193 10/01/2009 10/01/2010 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100, 000 CLAIMS MADE ® OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) 5 PERSONAL & ADV INJURY $1, 000 , 000 ❑ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 POLICY El PRO- LOC JECT X❑ C AUTOMOBILE LIABILITY CA 826 33 86 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) S2,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS ( Per person) X HIRED AUTOS . BODILY INJURY X NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG D EXCESS / UMBRELLA LIABILITY TH0900029 10/01/2009 10/01/2010 EACH OCCURRENCE , , E] OCCUR ❑ CLAIMS MADE AGGREGATE $5,000,000 ®DEDUCTIBLE RETENTION $100,000 B f3 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y N ANY PROPRIETOR/PARTNER/EXECUTIVE WC6987928 wc6987927 10/01/2009 10/01/2009 10/01/2010 X WC STATU- TORYLIMITS I OTH- ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE S1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -POLICY LIMIT $1, 000' 000 If es, describe under SPECIAL PROVISIONS below A OTHER COPS1952583 10/01/2009 1010112010 Each claim $5,000,000 Contractor Prof Aggregate $5,000,000 Deductible $250,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins is included as additional insured with respect to the General Liability policy where required by written contract. Insurance is Primary and Non -Contributory. A waiver of Subrogation is granted in favor of City of Fort Collins on the General Liability policy. see Attached endorsements. 55top Gap Coverage for the CER1'LFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn : opal Dick DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL P.O. Box 580 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ft. Collins CO 80522 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE IQ 61/yy 6- 0.. �srs�tero fY —fill., m eo ry 00 N to rn O O ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for Tetra Tech RMC Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver Co 80203 USA INSURER INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. L R LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY POLICY DESCRIPTION POLICY DATE POLICY EXPIRATION DATE LIMITS DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS following states: OH, WA, WY. Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 1 of 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Coverage afforded under this endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part. I. ADDITIONAL INSUREDS Section II - WHO IS AN INSURED, 1. is amended to include as an insured any person or organization described in paragraphs A through I below, whom you are required to add as an additional insured under a written contract or agreement. The written contract or agreement must be: 1. currently in effect or becoming effective during the term of this policy; and 2. Executed prior to " bodily injury property damage, " or " personal injury and advertising injury " . A. BY CONTRACT Any person or organization to whom you become obligated toyinclude as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of your operations or premises owned by or rented to you. However, the insurance provided will not exceed the lesser of: 1. The coverage and/or limits of this policy, or 2. The coverage and/or limits required by said contract or agreement. 100983 (2/09) Page 1 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 2 of 11 B. CONTROLLING INTEREST 1. Any person or organization having a greater than a 50% interest in you, but only with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease these premises. 2. The insurance afforded to these additional insureds under Paragraph I.B.1does not apply to structural alterations, new construction or demolition operations performed by or for that person or organization. C. CO-OWNER OR INSURED PREMISES A co-owner of insured premises co -owned by you and covered by this insurance but only with respect to their liability as co-owner of the premises. D. LESSOR OF LEASED EQUIPMENT 1. Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of such equipment leased to you by such person(s) or organization(s). 2. with respect to the insurance afforded to these additional insureds under Paragraph I.D.1, this insurance does not apply to any "occurrence" which takes place: a) after the equipment lease expires, or b) after the equipment is returned or no longer in your possession, whichever takes place later. E. MANAGERS OR LESSORS OF PREMISES Managers or Lessors of premises but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance under this paragraph does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 100983 (2/09) Page 2 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 3 of 11 2. structural alterations, new construction or demolition operations performed by or on behalf of such Managers or Lessors. F. MORTGAGEE, ASSIGNEE, OR RECEIVER 1. A mortgagee, assignee, or receiver but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of the premises by you. 2. The insurance afforded to the additional insureds under Paragraph I.F.1 does not apply to structural alterations, new construction or demolition operations performed by or for that mortgagee, assignee, or receiver. G. OWNERS, LESSEES, OR CONTRACTORS - COMPLETED OPERATIONS (1) Any Owner, Lessee or Contractor, but only with respect to liability arising out of " your work " performed for that additional insured and included in the " products -completed operations hazard " . H. OWNERS, LESSEES, OR CONTRACTORS - ONGOING OPERATIONS Any Owners, Lessees, or Contractors, but only with respect to liability arising out of your ongoing operations performed for that additional insured. This insurance does not apply to " bodily injury " or property damage " occurring after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) has been completed; or, (2) that portion of " your work " out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. I.STATE OR POLITICAL SUBDIVISION - PERMITS Any state or Political Subdivision, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for 100983 (2/09) Page 3 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA 100983 (2/09) page 4 of 11 which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. "Bodily injury, "property damage" or" personal and advertising injury" arising out of operations performed for the state or municipality; or b. "Bodily injury" or "property damage" included within the "products- completed operations hazard". II PRIMARY INSURANCE -ADDITIONAL INSUREDS where persons or organizations have been added to your policy as additional insureds to comply with insurance requirements of written contracts mandating primary coverage for such additional insureds relative to: a) the performance of your ongoing operations for the additional insureds; or b) " your work " performed for the additional insureds and included in the " products - completed operations hazard, then with respect to these additional insureds as defined above in this Section only, SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. - Other Insurance, a. - Primary Insurance , is deleted in its entirety and replaced with the following: This insurance is primary over any similar insurance available to any person or organization we have added to this policy as an additional insured to comply with insurance requirements of written contracts mandating primary coverage for such additional insureds relative to (a) the performance of your ongoing operations for the additional insureds, or (b) " your work " performed for the additional insureds and included in the " products -completed operations hazard. However, this insurance is primary over any other similar insurance only if the additional insured is designated as a named insured of the other similar insurance. we will not require contribution of limits from the other similar insurance if the insurance afforded is primary. 100983 (2/09) Page 4 Certificate No : 570036285283 INSURED Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver Co 80203 USA 100983 (2/09) page 5 of 11 III INCIDENTAL MEDICAL MALPRACTICE LIABILITY COVERAGE SECTION II - WHO IS AN INSURED, 2. a. (1) (d) is deleted in its entirety and replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services, except for " bodily injury " arising out of Incidental Medical Malpractice Injury" by any physician, dentist, nurse or other medical practitioner employed or retained by you unless such " bodily injury " is covered by another primary policy. However, the insurance provided hereunder to such persons will not apply to liability arising out of services performed outside of the scope of their duties as your employees. " Any series of continuous, repeated or related acts will be treated as the occurrence of a single negligent professional healthcare service, which will be assignable to the same policy and policy year in which the originating act occurred. SECTION V - DEFINITIONS - is amended to add: "Incidental Medical Malpractice injury" means "Bodily Injury" arising out of the rendering of or failure to render the following services: a. medical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food or beverages in connection therewith; or b. the furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. The Coverage provided by this endorsement does not apply to you or any insured if you are engaged in the business or occupation of providing any of the services described in the definition of "incidental Medical Malpractice Injury". IV. JOINT VENTURES / PARTNERSHIPS / LIMITED LIABILITY COMPANIES The paragraph under SECTION II - WHO IS AN INSURED which states: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. is hereby deleted and replaced with the following: 100983 (2/09) Page 5 Certificate No : 570036285283