HomeMy WebLinkAboutPB AMERICAS INC - INSURANCE CERTIFICATE (3)ACORO®
CERTIFICATE OF LIABILITY INSURANCE 10i1i2011
DATE (MM/DDNYYY)
1 10/25/2010
PRODUCER Lockton Companies, LLC-1 Kansas City
444 W. 47th Street, Suite 900
Kansas Cityy MO 64112-1906
(816) 960-9000
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.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED PB AMERICAS, INC.
1319027 ONE PENN PLAZA
NEW YORK NY 10110
INSURER A: Liberty Insurance Corporation
42404
INSURER B
INSURER C :
INSURER D :
INSURER E :
COVERAGES PA"R02 PJ THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
INSIIRFR131. AIITNnR17Fn RFPRFRFNTATIVF nR PRnniirFR amn TNF CFRTIFICATF FIni nFR
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
ADVL
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE (MM/DD/YY)
DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FRI OCCUR
TB7-621-094060-020
11/l/2010
10/1/2011
DAMAGE TO RENTED
PREMISES Ea occurence
$ 300,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 2,000,000
X CONTRACTUAL LIAB
GENERAL AGGREGATE
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 5,000,000
PRO -
POLICY JECT LOC
A
AUTOMOBILE LIABILITY
X ANY AUTO
AS7-621-094060-030
11/1/2010
10/1/2011
COMBINED SINGLE LIMIT
(Ea accident)e
$ 2,000000
BODILY INJURY
(Per person)
$ XXXXXXX
X ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$ XXXXXXX
X HIRED AUTOS
X NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
ANY AUTO
NOT APPLICABLE
OTHER THAN EA ACC
$ XXXXXXX
AUTO ONLY: AGG
$ XXXXXXX
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
❑ UMBRELLA
NOT APPLICABLE
$ XXXXXXX
$ XXXX3CXX
DEDUCTIBLE FORM
$ XXXXXXX
RETENTION $
A
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABTNE Y/N
ANYCERIMEMB R/PXCLUDE/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
WA7-62D-094060-010 (AOS)
WC7-621-094060-040 (OR
( )
I I/l/2010
11/1/2010
10/1/2011
10/1/2011
X I TOWIT LIM TS OER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
(PB #A) CITY FORT COLLINS MIST - CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS AS
RESPECTS GENERAL AND AUTO LIABILITY AS PERTAINING TO PB AMERICAS, INC. OPERATIONS, WHERE REQUIRED BY WRITTEN
CONTRACT.
10659688
CITY OF FORT COLLINS
RISK MANAGEMENT
PO BOX 580
FORT COLLINS CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2009/01)
988-2009 41ICC@tD CORPORATION. All rights reserved
I ne AUL)Ku name ana logo are reglsterea marks of ACORD
For questions regarding this certificate, contact the number listed in the 'Producer' section above and specify the client code 'PARBR02'.
f�>
October 25, 2010
To Whom it May Concern:
Enclosed is the November 1, 2010 to November 1, 2011 certificate of insurance for Parsons
Brinckerhoff Inc. If this certificate of insurance is no longer needed, please fax or email it back
to Andres Johnson at 816-783-9702 or anjohnson@lockton.com with "CANCEL" across the
front.
Please let us know if you have any questions upon review.
Sincerely,
LOCKTON COMPANIES, LLC.
� =6
Kyle Sill
Account Administrator for Susan Nixdorf
LOCKTON COMPANIES, LLC
444 W 47th St, Ste 900 / Kansas City, MO 64U2.1906
816-960.9000 / FAX: 816,960.9099
ww, IcAton.com