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HomeMy WebLinkAbout492167 TETRA TECH INC - INSURANCE CERTIFICATE-1 ® .. o CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 06126I2012 I 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 Aon Risk Insurance Services West, Inc. LOS An eles CA office 707 Wil Shire Boulevard Suite 2600 LOS Angeles CA 90017-0460 USA CONTACT NAME. INC.NHe Exq: (866) 283-782 NC. No.: (847) 953-5390 EAUUL ADDRESS: INSURER(B)AFFORDING COVERAGE NAlta INSURED INSURER A: National Union Fire Ins CO of Pittsburgh 19445 Tetra Tech RNC Inc. 1576 Sherman St., Suite 100 Denver CO 80203 USA INSURER B: Insurance Company of the State of PA 19429 INSURERC: Lexington Insurance Company 19437 INSURERD: Chartis Specialty Insurance Company 26883 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047592549 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 LTR TYPE OF INSURANCE INSR WVp POLICY NUMBER POILGI MMIDD I Mwo LIMITS A GENERAL LIABILITY GL EACH OCCURRENCE $2,000,005 X COMMERCIAL GENERAL LABILMY PREMISES Ea dcwrmnce $1, 000, 000 CLAIMS -MADE ❑% OCCUR MED EXP(Anyonepurard $10.000 PERSONAL B ADV INJURY $2.000,000 GENERA -AGGREGATE $4,000,000 GEMLAGGREGATE LIMB APPLIES PER: PRODUCTS -COMPIOP AGO $4,000,000 POLICY X PRO- X LOC A AUTOMOBILE LIABILITY CA 510 15 54 1 1 01 10/01/2013 COMBINED SINGLE LIMIT aam $2,000,000 BODILY INJURY (Per person) X ANY AUTO BODILY INJURY(Per.mden) ALL OWSCHEDULED S '�AUTOTOS NON-0WNEO PROPERTY DAMAGE X HIRED AUTOS X AUTOS Perarudem C X UMBRELLA LAB X OCCUR TH1200022 10/01/2012 10/01/2013 EACH OCCURRENCE $5,000,000 EXCESS LWB CLAIMS -MADE AGGREGATE $5,000,000 DEO I RETENTION A WORKERS COMPENSATION AND WC35896545 10 01/201210/01/2013 X we LIMIT$ ORTH B EMPLOYERS' LIABILITY YIN WC35896542 10/Ol/2012 10/Ol/2013 E.L. EACH ACCIDENT $1.000.000 B ANY PROPRIETOR I PARTNER I EXEOIRIVE NIA wC35896543 10/O1/2012 10/O1/2013 OFFICERIMEMBER EXCLUDEDi (ManOatory In NM E.L. DISEASE -EA EMPLOYEE $1,000,000 rcy desIrbe ender DESCRIPTION OF OPERATIONS below E L. DISEASE -POLICY LIMIT $1,000,000 D Contractor Prof COPS1952583 10/01/2012 10/01/2013 Each Claim $5,0001000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES Udlech ACORD 101, Addid.nel Remark. Schedule, N more apau I. raeulrad) 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. Box 580 Ft. Collins CO 80522 USA ��a ✓L�bt�srcVitaxec y�Cs�rd /!'[O�✓fta ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD `m " o CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD Y YYY) 092612012 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 A00 R15k InSUfaOCe services West, Inc. LOS Angeles CA office 707 Wilshire Boulevard Suite 2600 CONTACT NAME: PHONE (g66) 283-0122 FAX (847) 953-5390 (NC.No.Exq: we. No.: E-0WL ADDRESS: INSURER(S) AFFORDING COVERAGE NAC p Los Angeles CA 90017-0460 USA INSURED INSURERA: National union Fire Ins Co of Pittsburgh 19445 Tetra Tech, Inc. 1576 Sherman St., Suite 100 INSURER B: Insurance company of the State Of PA 19429 INSURER C: Lexington Insurance company 19437 Denver cc 80203 USA INSURERD: Chards Specialty Insurance company 26883 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047595971 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 LTM TYPE OF INSURANCE INBR WVD POLICY NUMBER MOLICYLFF MIpU MMIp LIMITS GENERAL LIABILITY GLIU/VI/Zuiz EAC'oCCURRENCE $2,000,000 X COMMERCIAL GENERAL LABILITY PREMISES Ea occunence $1,000, 000 CLAIMS-MAUDE X❑OCCUR MEp EXP(Any one Person) S10,000 PERSONAL g ADV INJURY $2,000,006 GENERAL AGGREGATE $4,000,000 DEW AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP ADD $4,000,000 POLICY % PRO- X LOG A AUTOMOBILE LWBILRY CA 510 15 54 10 01 201210/01/2013 COMBINED SINGLE LIMIT Eaauid n $2,000,000 BODILY INJURY (Per person) X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per doddent) AUTOS AUTOS X HIRED AUTOS % NONOWNED AUTOS PROPERTY DAMAGE Peracdd.rd C % UMBRELLALWB I, OCCUR TH1200022 10/01/2012 10/01/2013 EACH OCCURRENCE S5,000,000 EXCESS LIM CLAIMS -MADE AGGREGATE $5,000,006 DEO I RETENTION A e B WORKERS COMPENSATION AND EMPLOYERS.LWBILRY YIN PARTNER IE%ECUTIVE ANYPROPRIETOREXCLUDED? E%LLUDEDi N/A WC35896545 WC35896543 WC35896543 10/01 2012 10/01/2012 10/O1/2012 10/01/2013 10/01/2013 10/O1/2013 WC STATLL OTH- X TORY LIMITS ER El, EACH ACCIDENT $1, DOD, OOO EL DISEASE -EA EMPLOYEE $1,000, 000 (WndaWMEMBER NM Use.dloryin Ny aIPTIONlee under Use. OFO OF OPERATIONS Gebw E.L. DISEASE -POLICY LIMB $1,000, 000 D Contractor Prof COPS1952583 10/01/2012 10/01/2013 Each claim $5,000,006 Aggregate $5.000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Addhional Remarks Schedule, a more spew Is required) Stop Gap Coverage for the following States: OH, 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 Ft. Collins AUTHORIZED REPRESENTATIVE Attn: opal Dick PO Box l l i �� t�GLt�L a�7tG Fort Collins CO 80522-OSBO USA @1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD