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424631 KENNEDY / JENKS CONSULTANTS INC - INSURANCE CERTIFICATE
ACORDN, CERTIFICATE OF LIABILITY INSURANCE 10/I/2013 DATE(/YYYY) 9/28/20/2012 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 Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (816)960-9000 S '1 V`i \ CONTACT INC,000i FAX No Ext :INC,No E-MAIL INSURERS) AFFORDING COVERAGE NAIC If INSURER A: Zurich American Insurance Company 16535 INSURED KENNEDYIJENKS CONSULTANTS, INC. 1357983 303 SECOND STREET, SUITE 300 SOUTH SAN FRANCISCO CA 94107 INSURER B: LeXin ton Insurance Com anv 19437 NSURERC: INSURER COVERAGES KENJE01 PO CERTIFICATE NUMBER: 11996529 REVISION NUMRER- XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY Y N GL05833581-00 10/1/2012 10/1/2013 EACH OCCURRENCE 1000000 X COMMERCIAL GENERAL LIABILITY CIAIMS-MADE FRI OCCUR PMACETEaEoccurrence 1,000,000 MED EXP (My oneperson) 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 21,000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s 2,000,000 PRO- P V E T LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMITNE, accident) $XXXXXXX ANY AUTO NOT APPLICABLE BODILY INJURY (Per person) $ XXXXXXX AUTOWINED SCHEDULED BODILY INJURY (Per accident $ XXXXXXX NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE eracci Z $ XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY V I N ANY PROPRIETORIPARTNER ECIRIVE ❑ OFFICER/MEMBER EXCLUDED? IMyrt andorI In NH) DESCRIPTION OF OPERATIONS bebw NIA NOT APPLICABLE WC STATU- OTH- T RV LIMIT E.L EACH ACCIDENT s XXXXXXX E.L. DISEASE - EA EMPLOYEE V XXXXXXX E.L DISEASE -POLICY LIMIT XXXXXXX B PROFESSIONAL LIABILITY N N 026154151 10/1/2012 10/1/2013 $1,000,000 PER CLAIM $1,000,000 ANNUAL AGGREGATE DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, H more space is required) REF: 7144 GREASE TRAP INSPECTIONS. THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS WITH RESPECT TO GENERAL LIABILITY, WHERE REQUIRED BY WRITTEN CONTRACT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11996528 CITY OF FORT COLLINS FINANCIAL SERVICES, PURCHASING DIVISION 215 NORTH MASON STREET, 2ND FLOOR P.O. BOX 580 FORT COLLINS CO80522-0580 reserved the ACORD name and logo are registered marks of ACORD October 8, 2012 Kennedy/Jenks Consultants, Inc. 303 Second Street, Suite 300 South San Francisco, CA 94107 Re: General Liability and Professional Liability Certificates of Insurance October 1, 2012 — October 1, 2013 To Whom It May Concern: Enclosed are revisions to the previously issued general liability and professional liability insurance certificates for Kennedy/Jenks Consultants, Inc. for the October 1, 2012 — October 1, 2013 policy term. Please disregard any certificates received prior to this letter and replace them with the enclosed certificates. Should you have any questions, please feel free to contact me. Sincerely, LOCKTON COMPANIES, LLC Elizabeth Petry Account Executive Construction Practice Group LOCKTON COMPANIES, LLC 444 W 47di St, Ste 900 / Kansa± City. W 04112-1906 316960N00/ FAX: SIM60N99 u %ldockton.com Client#: 229 KENNECONSI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD" 10102/2012 ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton & Associates P. O. Box 12675 ONLY HOLDER. ALTER AND CONFERS NO RIGHTS UPON THE CERTIFICATE THIS CERTIFICATE DOES NOT AMEND, EXTEND OR THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland, CA 94604-2675 510 465-3090 David 9. Eckman INSURERS AFFORDING COVERAGE - INSURED- _ — INSURER A: American Automobile Ins. Co. Kennedy/Jenks Consultants, Inc. 303 Second Street, Suite 300 South = San Francisco, CA 94107 INSURER B' INSURER C: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR I rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDMI POLICY EXPIRATION DATE MMMD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENER^iu I AL LV181L1)Y CLAIMS MADE OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Any one ire) $ MED EXP (Anyone Person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIM ITAPPLIES PER: POLICY PRO - CT LOC PRODUCTS -COMPIOPAGG $ A AUTOMOBILEUABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS .. NON -OWNED AUTOS MZA80292982 10/01/12 10/01/13 COMBINED SINGLEUMD' (Eeent) a E1,DQD,DDD X BODILY INJURY (Per Penan) $ X BODILY INJURY _ (Per accident) E,- X PROPERTY DAMAGE- - (Per acodenl) S GARAGE LIABWry ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN EAACC AUTO ONLY: AGG $ $ EXCESS LIABILRY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE S E $ r $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WZP80006069 10/01/12 10/01/13 X WC STATUS OTH- ER E.L. EACH ACCIDENT $1,000,000 E. L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPER nONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS REF: 7144 Grease Trap Inspections. ADDITIONAL INSURED: The City of Fort Collins, its officers, agents and employees. Fort Collins, City of Financial Services, Purchasing Division 215 North Mason Street, 2nd Floor P.O. Box 580 Fort Collins, CO 80522-0580 SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL XXR§PAMXTP MAIL 30—DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, B 1fflf% 9PJ(xMAAAAAXKWXX WWMXXWAX X)OT)OHOMKMXXXXXKXMJIXIPAXAXX X)WAOeM)M AUTHORIZED ACORD zss-s (7r91)1 of 1 #S409568/M400156 DAC 0 ACORD CORPORATION 1988 ACORD,M Io/u2ot3 CERTIFICATE OF LIABILITY INSURANCE DA9/28/212 012 YY) TE /28/ 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 INSURERS), 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 Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (816)960-9000 CONTACT AIR No Ext : AAC No EMAIL ADDRESS, INSURER AFFORDING NAIC p INSURER A: Zurich American Insurance Company 16535 INSURED KENNEDY/JENKS CONSULTANTS, INC. 1357983 303 SECOND STREET, SUITE 300 SOUTH SAN FRANCISCO CA 94107 INSURER B: LRxin ton Insurance Compariv 19437 INSURER C: IN RER E: N RER F: COVERAGES KENJE01 PO CERTIFICATE NUMBER: 11996528 REVISION NUMBER: XXXXXXX 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 LM TYPE OF INSURANCE ADDL INSR SUBR YV POLICY NUMBER POLICY EFF POLICY EXP LIMITAM], A GENERAL LIABILITY Y N GLO5833581-00 10/1/2012 10/1/2013 EACH OCCURRENCE 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR PREMISETOE. RENTED 1,000,000 MED EXP (My oneperson) 5,000 PERSONAL B ADV INJURY $ 1000000 GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2 00O 000 POIPRO- JECT 7 L $ AUTOMOBILE LIABILITY ANY AUTO NOT APPLICABLE EOMaBBIINdEeD nttSINGLE LIMIT $XXXXXXX BODILY INJURY (Per person) $ XXXXXXX AUTOWNED SCHEDULED BODILY INJURY (Per accident $ XXXXXXX perram,0en1DAMAGE $ XXXXXXX HIRED AUTOS AUTO WNED $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DEO I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICEWMEMBER EXCLUOEDELUTIVE ❑ IMendatoryln Ni eyes OMer DESCRIPTIONIPTION OF OPERATIONS celow NIA NOT APPLICABLE STATU- OTH- T WC RY LIMITS EL EACH ACCIDENT $ XXXXXXX EL. DISEASE - EA EMPLOYEE XXXXXXX EL DISEASE - POLICY LIMIT XXXXXXX B PROFESSIONAL LIABILITY N N 026154151 10/1/2012 10/1/20I3 SI,000,000 PER CLAIM $1,000,000 ANNUAL AGGREGATE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ((Attach ACORD 101, Additional Remarks Schedule, if more space is required) REF: 7144 GREASE TRAP INSPECTIONS. THE CITY OF PORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE LISTED AS ADDITIONAL INSUREDS WITH RESPECTS TO GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT. VCR 1 Ir W N I C n V LUCK V ANIiCLLA I PLAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11996528 AUTHORIZED REPRESENTATIVE FORT COLLINS, CITY OF FINANCIAL SERVICES, PURCHASING DIVISION 215 NORTH MASON STREET, 2ND FLOOR P.O. BOX 580 FORT COLLINS CO 80522-0580 ACORD 25 (2010/05) © 9 8-2010 ACCVFDPORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD