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HomeMy WebLinkAbout101409 URS CORPORATION - INSURANCE CERTIFICATE (4)A� �® CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 041128 0 11 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