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HomeMy WebLinkAbout465997 MICHAEL BAKER JR INC - INSURANCE CERTIFICATE (4)A�R00 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YVl'Y) mlasrzol2 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 ACT, Risk Services Central, Inc. Pittsburgh PA Office CONTACT NAME: PHONE (g66) 283-)1ZI FAX (847) 953-5390 (MC.No.Extl: NC. N..: E-MAIL ADDRESS: Dominion Tower, loth Floor 625 Liberty Avenue INBURER(S)AFFORDING COVERAGE NAILi Pittsburgh PA 15222-3110 USA Is INSURED INSURER A Liberty Mutual Fire Ins CO 23035 Michael Baker Jr., Inc. 165 5. Union Blvd, suite 200 Lakewood CO 80228 USA INSURER B: Liberty Insurance Corporation 42404 INSURER C: Lloyds syndicate No. 2623 1128623 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047001967 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. Limits shown are as requested S LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER MMIDO MMIDOM'W LIMITS A GENERAL LIABILITY TB2681004145712 06/30/2012 06/30/2013 EACH OCCURRENCE S2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TORENTED—$1,000,000 PREMISES Ea occurrence CLAIMS -MADE ❑X OCCUR MI EXP (Any one person) S5, D00 PERSONAL S AOV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP ADD S4,000,000 POLICY X PRO. % LOC A AUTOMOBILE LIABILITY As2-681-004145-722 06/30/2012 06/30/2013 COMBINED SINGLE LIMIT Ea accident $1,000,000 ADS BODILY INJURY I Per person) % ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per acod'a) AUTOS AUTOS PROPERTY DAMAGE Per acci0enl X HIRED AUTOS % NON -OWNED AUTOS B X UMBRELLAUAB X OCCUR TH7681004145682 06/30/2012 06/3U/2013 EACH OCCURRENCE 110,000,000 EXCESSLIAJ3 CI -AIMS -MADE AGGREGATE $10,000,000 DEO RETENTION 110,000 R WORKERS COMPENSATION AND W 7680004145692 06/30/2012 06/30/2013 X WL is,OTH- TORV LIMITS ER EMPLOYERS' LIABILITY YIN ADS E.L EACH ACCIDENT $1,000,000 e ANY PROPRIETOR I PARTNER I EXECUTIVE OFFCERIMEMBER EXCLUDED NIA wc7681004145702 06/30/2012 06/30/2013 E.L. DISEASE -EA EMPLOYEE S1,000,000 IMandatory In NHl WI u yes mescal oma DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S1,000,000, C E8K)-PL-Primary QC1202675 - - 06/30/ZO12 06/30/2013 Per Claim $5,000,000' Professional & Poll Utl On Aggregate $5,000,000 SIR applies per policy ter s & condi ions DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES coach ACORD 101, Additional Remarks Schedule. if more space is required) For Named Insured Only: Attn: Dwight 5chock City of Fort Collins, its officers, agents and employees are included as j Additional insured with respect to the General Liability and Automobile Liability policies, per written contract with the Named insured. 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: Steve MCQUilkin Po Box 580 Fort Collins Co 80522 USA n/% `7LecYC �aviiict�d �O p iTi�ea ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD `m O 2 m A U U 1 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYVi'Y) 07MW2012 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 R15k services Central, Inc. Pittsburgh PA office CONTACT NAME: PHONE (966) 283JII2 FA% (842) 953-5390 INC. No. EnC AJC. No.: Dominion TOWer, 102h Floor 625 Liberty Avenue E.MNL ADDRESS: INSURER(B) AFFORDING COVERAGE NAIL p Pittsburgh PA IS222-3110 USA INSURED INSURER A Liberty Mutual Fire Ins Co 23035 Michael Baker 3r., Inc. 165 S. Union Blvd, suite 200 Lakewood CO 80228 USA INSURER B: Liberty Insurance Corporation 42404 INSURER C: Lloyds Syndicate No. 2623 1128623 INSURER D: NSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047004122 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER fMMIDD MMIDOM'YY LIMITS A GENERAL LIABILITY TB EAOHOCCURRENCE E2,000,000 % COMMERCIAL GENERAL LIABILITY PREMISES Ea orearence g1, 000, 000 CLAIMS-MADEOCCUR WED EXP(Any one person) S5,000 PERSONAL B ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GENLAGGREGATELIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S4,000,000 POLICY X PR T X LOC A AUTOMOBILE LIABILITY ASZ-681-004145-722 06/30/2012 06/30/2013 COMBINED SINGLE LIMIT Eaacutl m $1,000,000 ADS BODILY INJURY (Per Person) % ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS X HIREDAUTOS % NON -OWNED PROPERTY acutlenl DAMAGE AUTOS B X UMBRELLA UAB OCCUR TH7681004145682 06/30/2012 06/30/2013 EACH OCCURRENCE $10,000,000 E%CESS LIAR H CLAIMS -MADE AGGREGATE S10,000,000 DED RETENTION$10, 000 B WORKERS COMPENSATION AND wA768DO04145692 06/30/2012 06 30 2013 )( WL STATLL OTH. TORY LIMITS R EMPLOYERS' LIABILITY YIN ADS E.L. EACH ACCIDEM S1,000, 000 B PNY PROPRIETORIPARTNERIEX£CUTIVE OFFICERIMEMREft E%CLUDEOi NIA WC76E1004145702 06/30/2012 06/30/2013 E.L. DISEASE -EA EMPLOYEE S1,000,000 (Mandmoor In NH) wI u yee sesame onev OESCRIPTION OF OPERATIONS... E.L. DISEASE -POLICY LIMIT S1,000,000 C E&O-PL-Primary QC1202675 06/30/2012 06/30/2013 Per Claim S5,000,000 Professional & Pollution Aggregate S5,000,000 SIR applies per policy ter s & condi ions DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remarks Schedule, if more space is required) For Named Insured only: Attn: Dwight schock City of Fort Collins, its officers, agents and employees are included as Additional Insured with respect to the General Liability and Automobile Liability pGl icies, per written Contract with the Named Insured. 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 Attn: Of Fort Steve Collins MCQuilkin AUTHOREED REPRESENTATIVE X ox BO ED B Collinsi CO 80522 USA %nL�idE�J ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD `m