HomeMy WebLinkAbout100022 AECOM TECHNICAL SERVICES INC - INSURANCE CERTIFICATE (4)ACCMbr CERTIFICATE OF LIABILITY INSURANCE
DATE 03 25011 YYYY)
2/2011
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
Marsh Risk & Insurance Services
CA License #0437153
CONTACT
NAME:
PHONE FAX
.(A/Q.Na. A/c No:
EMAIL
ADDRESS
777 South Figueroa Street
Los Angeles, CA 90017
Add Lori Bryson 213346-5464
PRODUCER
CUSTOMER to
INSURERS AFFORDING COVERAGE
Rate#
06510B-PROF-CAS'2-11 12 Denver CO ADWOA TBD
INSURED
INSURER A : Zurich Amenum Insurance Company
16535
AECOM Technicul Services, Inc.
EDAW, Inc.
71717th Street, Suite 2600
INSURER B : N/A
NIA
INSURER C : NIA
NIA
Denver, CO 80202
INSURER D ;NIA
NIA
INSURER E : NIA
NIA
INSURER F :
COVERAGES CERTIFICATE NUMBER: LOS-001242562-02 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
JumSUM
POLICY NUMBER
MM LICY EFF
IDDYYYY
POLICY EXP
Y MM/DD YYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE I X1 OCCUR
GILD 596589103
04/01/2011
04/012012
EACH OCCURRENCE
$ 1,000.000
DAMAGE TORENTED
PREMISES Ea occurrence
$ 1000000
N ED EXP (Any one person)
$ 5,000
PERSONAL &ADV INJURY
$ 1.000,000
GENERAL AGGREGATE
$ 1,000,000
GEN'L AGGREGATE
POLICY
LIMIT APPLIES PER.
PRO-1-1 LOG
PRODUCTS - COMPIOP AGG
$ 1•000•000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP 596589303
04/012011
04/012012
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Peraccident)
$
$
$
UMBRELLA LUIB
EXCESS LIAR
OCCUR
CLAIMS1MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
WORKERS COMPENSATION
ANDEMPLOYERTUABIUTY YIN
ANY PROPRIETORIPARTNERIEXECUTWE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatary in NH)
If yes, deSQibe under
DESCRIPTION OF OPERATIONS belay
NIA
VJC STATU- OTH-
E.L. EACH ACCIDENT
$
EL DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT I
$
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
RE: Mason Project.
THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS, AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED FOR GL & AL COVERAGES, BUT ONLY AS RESPECTS WORK PERFORMED BY OR ON
BEHALF OF THE NAMED INSURED.
City of Fart Collins
P.O. Box 590
Fat Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
David Denman .��/✓f�.o6M/I�O�/
111)1988-2009 ACORD CORPORATION. All riahts reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD