HomeMy WebLinkAbout101409 URS CORPORATION - INSURANCE CERTIFICATE (4)A� �® CERTIFICATE OF LIABILITY INSURANCE
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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
Willie Insurance Services of California, Inc.
26 Century Blvd.
P. 0. Box 305191
Nashville, TN 37230-5191
CONTACT
ME:
PHONE 877-945-7378 FAX
wC N0) 888-467-2378
A
A-PIL certificates@willis.com
I NSUR ER(S)AFFORDING COVERAGE
NAICe
INSURERA: National Union Fire Ins Co of Pittsburgh
19445-100
INSURED
UPS Corporation
INSURER B: Zurich American Insurance Company
16535-100
INSURERC: Illinois National Insurance Co.
23817-001
600 Montgomery Street, 26th Floor
San Francisco, CA 94111
INSURER D: Insurance Company of the State of PA
19429-100
INSURER E: Lexington Insurance Company
19437-000
INSURER F: Lloyd's of London & British Companies
15792-004
COVERAGES CERTIFICATE NUMBER: 15890035 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
rypE OFINSURANCE
DO'
SUBSR DI
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
GENERAL LIABILITY
GL4870829
5/1/2011
6/1/2012
EACHOCCURRENCE
S 2,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES Ea mcurence
$ 1,000,000
MED EXP(My one Person)
$ 10,000
CLAIMS -MADE OCCUR
PERSONAL& ADV INJURY
$ 2,000,000
X XCU, BFPD
X Contractual Liability
G EN ERAL AGG REGATE
$ 2,000,000
G ENI AGGREGATE LIMIT APPLI ES PER:
PRODUCTS - COMP/OP AGG
S 2,000.000
PRO- LOC
POLICY rX I
$
B
BAP938521502
5/1/2011
6/1/2012
COMBINED INGLELIMIT(Eaaccident)$
2,000,000
BODILY INJURY(Per person)
$
ANY AUTO
AOSCHEDULED
AUTOS AUTOS
FMOBILIELIABILITIf
BODILY INJURY(Per accident )
$
HIREDAUTOS NON -OWNED
AUTOS
PROPERTYDAMAGE
Per accident
$
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION$
$
C
A
C
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YI
/MeneeEmry in NHjR EXCLUDED?
0 yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
WC20635052
WC20635051
WC20635053
WC20635054/WC20635055
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2012
1/1/2012
1/1/2012
1/l/2012
X IT R
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
E.L. DISEASE -POLICY LIMIT IS
2.000,000
E
015438088
5/1/2011
6/1/2012
F
Professional Liability
PE1105150
5/1/2011
5/1/2012
$1,000,000 Each Claim
w/Limited Contractual -
$1,000,000 Aggregate
Claims Made Policy
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach Acord 101, Addilonel Remarks Schedule, H more Space is required)
RE: Project No.: 22236040 - Dry Creek Basin Flood Control Project
The Workers' Compensation coverage shown above does not apply in monopolistic states. In the
States of ND, ON, WA and WY, Workers' Compensation coverage is provided by the State Fund. In
those States, the above -referenced policies provide Stop -Gap Employers' Liability only.
..�uww�n _ I.NIVL.CLLH I IUIN
City of Fort Collins
Attn: Opal Dick
215 North Mason Street
2nd Floor
P.O. Box 580
Fort Collins, CO 80522-0580
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
' •I—
5 01988-2010 ACORD
Coll:3343525 Tpl:1257950 Cart:
ACURD 25 (2010105) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOC#:
4 ADDITIONAL REMARKS SCHEDULE Page 2 of _2
AGENCY
Willis Insurance Services of California, Inc.
POLICY NUMBER
See First Page
CARRIER NAIC CODE
NAMED INSURED
URS Corporation
600 Montgomery Street, 26th Floor
San Francisco, CA 94111
EFFECTIVE DATE: See First
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
Workers Compensation policies apply as indicated below:
WC20635051 - CA
WC20635052 - FL
WC20635053 - TX
WC20635054 - AK, AL, AZ, DC, DE, HI, IA, IL, IN, KS, LA, MD, ME, MI, MO, MS, MT, NC, NE, NH, NJ,
NM, OK, PA, RI, SC, SD, IN, VA, VT
WC20635055 - AR, CO, CT, GA, ID, KY, MA, MN, ND, NV, NY, OH, OR, UT, WA, WI, WV, WY
ACORD 101(200at01) Coll:3343525 Tp1:1257950 Cert:15890035 02008
The ACORD name and logo are registered marks of ACORD
TION. All rights reserved