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HomeMy WebLinkAbout492167 TETRA TECH CONSTRUCTION SERVICES INC - INSURANCE CERTIFICATE (3)AC 0® CERTIFICATE OF LIABILITY INSURANCE DATE0(M ID201) 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 Angeles CA Office 707 Wilshire Boulevard Suite 2600 LOS Angeles CA 90017-0460 USA CONTACT NAME: A/CNNo. Ext): (866) 283-7122 FAX No.): (847) 953-5390 E-MAIL ADDR PRODUCER CUSTOMER ID#:570000036654 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co Of Pittsburgh 19445 Tetra Tech, Inc. 1576 Sherman St., Suite 100 Denver Co 80203 USA INSURERB: Insurance Company of the State of PA 19429 INSURERC: Chartis specialty Insurance Company 26883 INSURER D: Lexington Insurance Company 19437 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570040200753 REVISION NUMBER: 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD MM DD LIMITS A GENERAL LIABILITY GL4581561 ID791T= 1010112011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY SIR applies per policy terns & conditions AMA O N PREMISES Ea occurrence $1,000,000 CLAIMS-MADE x] OCCUR MED EXP (Anyone person) ' $10 , 000 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-JECT X LOC A AUTOMOBILE LIABILITY CA 826 36 72 10 01 2010 10 01 2011 COMBINED SINGLE LIMIT accident) $2 , 000, 000 X ANY AUTO BODILY INJURY ( Per person) _ ALL OWNED AUTOS BODILY INJURY (Per accident) SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS Per accident X NON OWNED AUTOS D X UMBRELLA LIAR EXCESS LIAB H OCCUR CLAIMS -MADE TH1000027 SIR applies per policy terns 10 01 2010 & co ndl 1010112011 ions EACH OCCURRENCE - $5,000,000 AGGREGATE $5,000,000 DEDUCTIBLE X RETENTION $100,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE [ n- OFFICER/MEMBER EXCLUDED? 1 V (Mandatory in NH) LJ N / A WC14770806 . _ _ _ 10/01/2010 10/01/2011 1 WC STATU- OTH- X TORY LIMITS I ER E.L. EACH ACCIDENT, I $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 C Contractor Prof CoP51952583 10/01/2010 10/01/2011 Each Claim $5,000,000 Deductible $250,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 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 Ft. Collins AUTHORIZED REPRESENTATIVE Attn: opal Dick Po Box Mn A�"f lw yl X JL Fort Collinsi CO 80522-0580 USA ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD M N n o N 0 O O Z m r tD V N 0