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HomeMy WebLinkAbout101409 URS CORPORATION - INSURANCE CERTIFICATE (2)A 10CERTIFICATE OF LIABILITY INSURANCE DATE OHI2812012 YYYY) 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 endorsement(s). PRODUCER MARSH RISK & INSURANCE SERVICES 345 CALIFORNIA STREET, SUITE 1300 CALIFORNIA LICENSE NO.0437153 SAN FRANCISCO, CA 94104 CONTACT NAME: iAl2C,N ot FAX No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC a INSURER A: National Union Fire Ins Co Pittsburgh PA 19445 URSCOR-ALL: PROF 12-13 SF CA 222360 INSURED UPS Corporation 600 Montgomery Street, 261h Floor ' 1 �� (� INSURER B: Zurich American Insurance Company 16535 INSURER C: Illinois National Ins Co 23817 INSURER D: Insurance Company Of The State Of PA 19429 San Francisco, CA 94111 INSURER E: Lexington Insurance Company 19437 INSURER F : Lloyd's Of London & British Companies 15792 COVERAGES CERTIFICATE NUMBER: SEA -002271256-05 REVISION NUMBER:1 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 Tfl TYPE OF INSURANCE ADD L SUBR POLICY NUMBER POLICY EFF MM/OD/YYVY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY GL4870829 0510112011 1110112012 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Es occurrence $ 1,000,000 CLAIMSMADEI X1 OCCUR MED EXP (Anyone person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 X XCU, BFPD X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY FX I RE' -LOG B AUTOMOBILE LIABILITY BAP938521502 0510112011 1110112012 COMBINED SINGLE LIMIT Ea accident 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALLOWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE IS AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION S A D C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEFUEXECunvE YIN (MandaOFFICEIoryinN REXCLUDED? (Mandatory in NH) NIA SEE ATTACHED ACORD 101 SEE ATTACHED-ACORD101 SEE ATTACHEDACORD101 0110112012 01101/2012 01/01/2012 01/01/2013 0110112013 01/01/2013 X ARV LAOTH- E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE- EA EMPLOYE $ 2,000,000 If yes, describe under DE SCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 2.000.000 E Prof. Liah w/Hold Contractual 015438088 05/0112011 11/0112012 Each Claim $1.000,000 F Claims Made l Retro 1117-1938 PE11051501PE1105490 05/01/2011 11/0112012 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Project No.: 22236040 - Dry Creek Basin Flood Control Project City of Fort Collins Ann: 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 of Marsh Risk & Insurance Services Lynne Harrington ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: URSCOR LOC #: San Francisco ACII ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH RISK & INSURANCE SERVICES NAMEDINSURED URS Copoialion 600 Montgomery Street, 261h Floor San Francisco, CA 94111 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance The Workers Compensation coverage shown does our apply in monopolistic states. In the States of NO, OH. WA and WY WorkersCompensation coverage is provided by the State Fund. In those Slates, the above - referenced policies provide Stop Gap Employers Liahihly unity. Workers Compensation policies apply as indicated below: Insurer A: National Union Fire his Co Pittsburgh. PA NAIC# 19445100 WC 021417576 - CA Insurer D: Insurance Company Of The State 01 PA NAIC# 19429100 WC 021417580 - MA, WI (Stop Gap ND, OH, WA, WY) WC 021417581 - AK, AL, AR, AZ, CO, OF, GA, ID, KS, KY, MD, ME, MO, MS, MT, NC, NH, NM, NV, OK, OR, PA, RI, SC, SO, TN, Of, VA, VT, WV WC 021417585 - MN WC 021417578 -NY Insurer C: Illindis National Ins Co NAIC#23817001 WCO21417577 FL WC 021417582 - CT, DC, HI, IA, IL, IN, LA, MI, NE, NJ WC 021417579 - TX ACORD 101 (2008/01) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A� EX CERTIFICATE OF LIABILITY INSURANCE DATE12012 YYYY oazerza z 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 MARSH RISK & INSURANCE SERVICES 345 CALIFORNIA STREET, SUITE 130D CONTACT NAME: , PHONE FAX .No E MC No): E-MAIL ADDRESS: CALIFORNIA LICENSE NO.0437153 SAN FRANCISCO, CA 94104 INSURER(S) AFFORDING COVERAGE NAICIf INSURER A; National Union Fire Ins Co Pittsburgh PA 19445 URSCOR ALL-PROF-12-13 SF CA 222360 INSURED URS Corporation fiW Montgomery Street, 26th Floor San Francisco, CA 94111 INSURER B: Zurich American Insurance Company 16535 INSURER C ; Illinois National Ins Co 23817 INSURER D: Insurance Company Of The State Of PA 19429 E: Lexinglon Insurance Company INsuRERRER 19437 INSU: Lloyds Of London & British Companies F 15792 COVERAGES CERTIFICATE NUMBER: SEA-00229B495 04 REVISION NUMBER:I 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 LTR TYPE OF INSURANCE ADDL SUDR POLICY NUMBER MM1DiFDD/YYVY MEFF M LICY EXP /OONYVV LIMITS A GENERAL LIABILITY GL4870B29 0510112011 1110112012 EACH OCCURRENCE $ 2.000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP(Any we person) $ 10,000 CLAIMS -MADE MOCCUR PERSONAL & ADV INJURY $ 2,000,000 X XCU, BFPD X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO LOC B AUTOMOBILE UABILII BAP938521502 0510112011 1110112012 CcOMBINED SINGLE LIMIT ecltlant 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMSMADE DIED I I RETENTION$ $ A WORKERS COMPENSATION SEE ATTACHED -ACORD 101 0110112012 0110112013 X wCSTATu- O7H- D C AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N OFFICERIMEMBER EXCLUDED? a (Mandatory in NH) N/A SEE ATTACHED -ACORD 101 SEE ATTACHED-ACORD 101 0110112012 0110112012 0110112013 01/0112013 E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 Ity descries under DESCRIPTION OF OPERATIONS below E Prof. Liab w/Lmtd Contractual 015438088 05/01/2011 11/0112012 Each Claim $1,000,000 F Claims Made l Relm 11-17-1938 PE11051501PE1105490 05/0112011 1110112012 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: Final No.: 22236040 - Dry Creek Basin Flood Control Projecl CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Arm. Opal Dick THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 North Mason Street ACCORDANCE WITH THE POLICY PROVISIONS. 2nd Flow P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 of Marsh Risk & Insurance Services Lynne Harrington 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: URSCOR LOC #: San Francisco A ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH RISK & INSURANCE SERVICES NAMED INSURED URS Corporation 600 Montgomery Street 261h Floor San Francisco, CA 94111 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance The Workers Compensation coverage shown Ones not apply in monopolistic states. In the States of NO, OF, WA art WY WorkersCompensation coverage is provided by the State Fund. In those States, the above referenced policies provide Stop -Gap Employers' Liability only. Workers Compensation policies apply as indicated below: Insurer A. National Union Fire Ins Co Pittsburgh, PA NAIC# 19445100 WC 021417576 -CA Insurer D. Insurance Company Of The State Of PA NAIC# 19429100 WC 021417580 - MA, WI (Stop Gap - NO, OH, WA, WY) WC 021417581 - AS AL, AR, AZ, CO, HE, GA, ID, KS, KY, MD, ME, M0. MS, MT, NC, NH, NM, NV, OK, OR, PA, RI, SC, SD, TN, UT, VA, VT, WV WC 021417585 -MN WC 021417578 -NY Insurer C. Illiwis National Ins Co NAIC#23817001 WC 021417577 -FL WC 021417582 - CT. DC, HI. IA, IL, IN, LA, MI, NE, NJ WC 021417579 - TX ACORD 101 (2008/011 2008 The ACORD name and logo are registered marks of ACORD All rights reserved - Marsh Risk & Insurance Services 345 California Street, Suite 1300 San Francisco, CA 94104-2679 California Insurance License #0437153 888-769-3873 urs.renewalcarts@rnarsh.com www, marsh.com August 27, 2012 To Whom It May Concern: Attached is a Certific-ef—Irrsvrani which provides evidence of the current insurance policies in place46rURS Corporation for the period 5/1/2011 to 11/1/2012. Marsh will issue another Certificate or—Y s�nce evidencing Insurance coverage for the 11/1/2012 renewal term in the near future. If you have any questions, please do not hesitate to contact us between 7AM - 6PM (PST) at the following: Telephone: 1-888-769-3873 E-Mail: urs.renewalcertsc& marsh. corn Sincerely: Marsh Certificate Team MARSH 6 MCLENNAN LEADERSHIP, KNOWLEDGE, SOLUTIONS- WORLDWIDE. COMPANIES