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HomeMy WebLinkAbout492167 TETRA TECH INC - INSURANCE CERTIFICATE (2)ACOROes CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 1winoli 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 endomement(s). PRODUCER Aon Risk Insurance Services West, Inc. Los Angeles CA offi Ce 707 Wilshire Boulevard Suite 2600 CONTACT NAME: PHONE ) FAX (MC.N(R66283-]122 o.EsU: ," No.: (807) 953-5390 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAICa LOS Angeles CA 90017-0460 USA INSURED ` `^1 Tetra Tech, Inc. v� �"T V` 1 1576 Sherman St., Suite 100 ` INSURER A: National union Fire Ins Co of Pittsburgh 19445 INSURER B: Insurance Company Of the State of PA 19429 INSURER C: Chartis Specialty Insurance company 26883 Denver Co 80203 USA INSURERD: Lexington Insurance Company 19437 INSURER E: INSURER F: GUVEHAGE5 GEKI11-IGAIE NUMBER: b/UU44UU1Z99 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. Omits shown are as requested LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMiDDhYv`Y) (MMfDDfYYYn LIMITS A GENERAL LIABILITY GL 1 1 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occunance S1,000,000 CLAIMS -MADE DOCCUR NED EXP(Any one person) $10,000 PERSONAL S ADV INJURY E1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $2,000,000 POLICY % PRO- % LOC A AUTOMOBILE LIABILITY CA 170 73 788 10 01 2011 10 01 2012 COMBINED SINGLE LIMIT (Ed accident) E2,000, 000 BODILY INJURY( Per person) % ANY ALTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE Peraccilent D % UMBRELIA LLIB X OCCUR TH1100027 10/01/2011 10/01/2012 EACH OCCURRENCE S5,000,000 EXCESS UAB Cl-AIMS-MADE AGGREGATE S5,000,000 DEO RETENTION B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC20635697 WC20635698 10/01/2011 10101120111010112012 10/01/2012 WC STATU- OTR X1 TORY LIMITS EL EACH ACCIDENT S1,000,000 B IUFICER/RIETOR E%0.UDER11111 NIA WC20635699 10101120111010112012 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory In Nlq If mewe,.ro.r DESCRIPTION OF OPERATIONS Irobw E.L. DISEASE -POLICY LIMIT S1,000,000. G Contractor Prot COPS1952583 10/01/2011 101GI 2012 Each Claim — $5, 000.000 Aggregate E5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Adach ACORD 101, MEitlonal Remarks Schedule, Hmom space is repuirttl) Stop Gap Coverage for the following states: OH, WA, W. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE MILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, City Of Ft. Collins AUTHORIZED REPRESENTATIVE Attn: opal Dick PO Box 580 Fort Collins CO 80522-0580 USA ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD s 6� ® " o CERTIFICATE OF LIABILITY INSURANCE DATE(MMJOD/YYYY) DO,QD„ 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(les) 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 endomement(s). PRODUCER AOn Risk Insurance Services West, Inc. LOS Angeles CA Office 707 Wilshire Boulevard Suite 2600 CONTACT NAME FAX WC No. Exo: (866) 283-7122 (AX No.): (847) 953-5390 EawL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC R LOS Angeles CA 90017-0460 USA INSURED INSURER A: National Union Fire Ins CO of Pittsburgh 19445 Tetra Tech RMC Inc. 1576 Sherman St., Suite 100 Denver Co 80203 USA INSURERS: Insurance Company of the State Of PA 19429 INSURER a Chartis Specialty Insurance Company 26883 wsuaea o: Lexington Insurance Company 19437 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER' 5/00439912/b 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. Limbs shown areas requested LTR TYPE OF INSURANCE INS R WVD POLICY NUMBER MWD& MWDD LIMITS A GENERAL LWBILnY GL4871170 EACHOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIA&LITY CLAIMS-MADE X❑ OCCUR PREMISES Ea ocrrence w S1,000,000 MED EXP(my one person) S10,000 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE S2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S2,000,000 POLICY X PR6 % LOC A AUTOMOBILE LIABILITY CA 170 73 788 10 0 2011 10 01 2012 COMBINED SINGLE LIMIT pecdeno S2,000,001) -Ea BODILY INJURY( Per person) X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS X HIREO AUTOS X NON-0WNED AUTOS PROPERTY DAMAGE Per accident D X OCCUR TH1100027 10/01/2011 10/01/2012 EACH OCCURRENCE S5,000,000 IUMBRELLALUUI EXCESS UAB CLAIMS -MADE AGGREGATE $5,000,000 DED RETENTION . B e e WORKERS EMPLOYERSOMP�EILISDATION AND YIN ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) [flNIA WC20635697 WC20635698 WC20635699 10 O1/201110 10/01/2011 30/Ol/2011 01/2012 10/01/2012 10/Ol/2012 X TORY LIMITS ORµ EL EACH ACCIDENT $1,000,000 E. L. DISEASE -EA EMPLOYEE $1,000,000 Adesadbe unde. SC UPTON OF OPERATIONSbebw E.L. DISEASE -POLICY LIMB S1,000,000 C Contractor Prof COPS1952583 10/01/2011 10/01/2012 Each claim - - 55,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAaach ACORD 101, Addldonen Remarks Schedule, N more apace le,"I City of Fort Collins is included as additional insured with respect to the General Liability policy where required by written contract. Insurance is Primary and Non -Contributory. A Waiver of subrogation is granted in favor Of City of Fort Collins on the General Liability policy. See Attached endorsements. SStop Gap Coverage for the following states: ON, 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 Fort Collins AUTHORIZED REPRESENTATIVE Attn: Opal Dick P.O. Sox 580 FL_ Collins CO 80522 USA cJ�On ✓L�Ka/faAr�fdsea �ef�tAad „��„✓v+4 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD do N m de en n N