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HomeMy WebLinkAbout492167 TETRA TECH CONSTRUCTION SERVICES INC - INSURANCE CERTIFICATE (2)A CORD.) NSURANCE„ „ ' y z . DATE (MM/DD/YY 09/27/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Aon Risk Insurance Services West, Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE , Los Angeles CA office 707 Wilshire Boulevard DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. Suite 2600 COMPANIES AFFORDING COVERAGE LOs Angeles CA 90017-0460 USA COMPANY Travelers Property Cas Co of America A PHONE- 866 283-7122 FAX- 847 953-5390 INSURED COMPANY Tetra Tech Construction Services, Inc. B 4304 E. 60th Avenue Commerce City CO 80022 USA COMPANY C COMPANY D sk COVERAGES01 ..: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATIO: DATE (MM/DD/YY) COVERED PROPERTY LIMITS PROPERTY BUILDING CAUSES OF LOSS PERSONAL PROPERTY BASIC BUSINESS INCOME w/o E.- Ex, BROAD EXTRA EXPENSE SPECIAL BLANKET BUILDING EARTHQUAKE BLANKETPERSPROP FLOOD BLANKET BLDG & PP A X INLAND MARINE KTJCMB MA 10/01/10 10/01/11 x Leased or $1,000,000 TYPE OF POLICY Equipment Flotr CAUSES OF LOSS NAMED PERILS OTHER x CRIME TYPE OF POLICY BOILER & MACHINERY ' OTHER " LOCATION OF PREMISES \ DESCRIPTION OF PROPERTY RE: Mr. John Stephen Bid Job #5738 1 i SPECIAL CONDITIONS / OTHER COVERAGES CERTIFICATEIiOLDEc•, CANCELLATION ' ! - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE i City Of Fort Collins EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL P.O. BOX 580 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, i Fort Collins CO 80522 USA BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD?24 ` /9 ,. ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE09M 5/D201) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Aon Risk Insurance Services West, Inc. LOS An el es CA Office 707 Wilshire Boulevard Suite 2600 LOS Angeles CA 90017-0460 USA CONTACT NAME: (A/c No. Ext): (866) 283-7122 FAX No ): (847) 953-5390 E-MAIL ADDRESS PRODUCER CUSTOMER to#:570000036654 INSURER(S) AFFORDING COVERAGE NAIC # - INSURED INSURER A: National union Fire Ins Co Of Pittsburgh 19445 Tetra Tech Construction Services, Inc. 4304 E. 60th Avenue Commerce City CO 80022 USA INSURERB: Insurance Company of the State of PA 19429 INSURER C: Lexington Insurance Company 19437 INSURER D: INSURER E: INSURER F: rovFRCGiFS CFRTIFICOTF NUMHI-R' h/0041)1H4444 Kt VIaILJN NUMIStK: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD (MMIDDfYYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY GL SIR applies per policy terns & conditions EACH OCCURRENCE $1,000,000 DAMAGE TORENTE PREMISES Ea occurrence $1,000,000 MED EXP(Anyone person) $10,000 CLAIMS -MADE x1 OCCUR 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 X PRO-JFCT X LOC A AUTOMOBILE LIABILITY CA 826 36 72 10 01 2010 10 01 2011 COMBINED SINGLE LIMIT Ea accident $2 , 000, 000 BODILY INJURY ( Per person) X ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per accident) SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident X NON OWNED AUTOS C X UMBRELLA LIAB EXCESS LIAR H OCCUR CLAIMS -MADE TH1000027 SIR applies per policy terns 10 01 2010 & conditions 10 01 2011 EACH OCCURRENCE $5 , 000, 000 AGGREGATE $5,000,000 DEDUCTIBLE X RETENTION $100,000 B - WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR: PARTNER] EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A WC14770806 - - - - 10/01/2010 - 10/01/2011 OTH- X Ty RY LIMITS IER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 H_-IJ I . DESCRIPTION O PERATIONS / LOCATIONS I VEHICLES (A ch ACORD 101, Additional Remarks Schedule, if more space is required) RE: Mr. ohn Stephen Bid lob #5738. Stop Gap coverage for the following states: OH, WA, WY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE P.O. BOX 580 Fort Collins Co 80522 USA ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD m m a, 00 8 O O Z 0) t0 V 1_ N 0