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HomeMy WebLinkAbout490561 CH2M HILL ENGINEERS INC - INSURANCE CERTIFICATE"v �® CERTIFICATE OF LIABILITY INSURANCE DATE IYYYY) 04I21/20,4 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 USA INC. 122517TH STREET, SUITE 1300 CONTACT NAME: PHONE FAX H E-MAIL DENVER, CO 80202-5534 INSURE S AFFORDING COVERAGE NAIC 0 INSURER A: GreenYlkh lnstrame Company 22322 15114-12345.5EX2P-14115 029032 CA INSURED Q CH2M HILL ENGINEERS, INC. 4 l t 6 9193 S. JAMAICA STREET I J INSURER B: WA NIA INSURER C XL Insurance America, Inc. 24554 INSURER D : Zurich American Insurance Co 16535 ENGLEWOOD, CO 80112-5946 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002455018-05 REVISION NUMBER; 2 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 A POLICY NUMBER MMDDY EFF MM/DDm P LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 1,500,000 A X COMMERCIAL GENERAL LIABILITY RGE500025503 05/0112014 VA112015 $ 1,500,000 CLAIMS -MADE M OCCUR MED EXP one reon) $ X $500,000 SIR PERSONAL a ADV INJURY $ 1,500,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 5,000,000 It POLICY PRO- LOG JECT - AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT 2000000 A X ANY AUTO RAD500025403(ADS) 05/0112014 OSA1/2015 BODILY INJURY (Par parson) S BODILY INJURY (Per accident) $ A ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NNONOSWNED RAD500025603(MA) 0510112014 O5/0112015 PROPERWerdTaY nfi DAMAGE $ _ s UMBRELLA LULB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- C C AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE a OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA RWD500025203 (ADS) RWR500025303 (WI) 05101YY014 05101I2014 05/012015 05/01@015 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1,000,000 f yes, descrioe under DESCRIPTION OF OPERATIONS WIM E.L. DISEASE -POLICY LIMIT $ 1,000,000 D PROFESSIONAL LIABILITY' EOC3829621-12 05/01/2014 0510112015 Each Claim 8 Aggregate $2,000,000 Each Policy Period DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: ON -CALL FOR RFP 7675 CONSULTING ENGINEERING SERVICES WTP FACILITY DESIGN AND CONSTRUCTION SERVICES FOR CAPITAL IMPROVEMENTS, THE CITY ITS OFFICERS, AGENTS AND EMPLOYEES IS INCLUDED AS AN ADDITIONAL INSURED ON THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY POLICIES AS REQUIRED BY WRITTEN CONTRACTOR AGREEMENT. *FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED. THE LIMIT WILL BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. CITY OF FORT COLLINS, COLORADO ATTN: PURCHASING DEPARTMENT P.O. BOX 580 FORT COLLINS, CO 80522 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 USA Inc. Sharon A. Hammer (-z W4� 6� - L7v� � (V 1953-ZUIU AGUKU CUKPUKAI IUN. All rlgnts reserVea. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ENDORSEMENT # 009 This endorsement, effective 12:01 a.m , May 01, 2014 forms a part of Policy No.RAD500025403 issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company TI IIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason, other than nonpayment of premium, or if coverage is materially reduced, advanced written notice will be mailed or emailed to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies) Mailing Address: Number of Days Advanced Notice of Cancellation: Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less than 15 days prior to the 60 days of notice of cancellation, non -renewal or material reduction in coverage 60 days For the purpose of this endorsement, non -renewal shall mean solely non -renewal of the Policy and shall not include Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits, an increase in the deductible or self -insured retention or the application of a Policy exclusion not contemplated at Policy issuance. Alf other terms and conditions of the Policy remain unchanged. (Authorized Representative) MANUS 0 2014 X.L. America Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT # 027 This endorsement, effective 12:01 a.m., May 01, 2014 forms a part of Policy No.RGE500025503 issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason or if coverage is materially reduced, or coverage is cancelled for non-payment of premium advanced written notice will be mailed or emailed to the person or entity according to the notification schedule shown below: Name of Person or Entity Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less than 15 days prior to the 60 days of notice of cancellation, non - renewal or material reduction in coverage Number of Days Mailing Address: Advanced Notice of Cancellation: 60 days For the purpose of this endorsement, non -renewal shall mean solely non -renewal of the Policy and shall not include expiration or Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits, an increase in the deductible or self -insured retention or the application of a Policy exclusion not contemplated at Policy issuance, All other terms and conditions of the Policy remain unchanged. (Authorized Representative) MANUS © 2014 X.L. America, Inc. All Rights Reserved May not be copied without permission. F.ndorsement 4 1 Notification to Others of Cancellation �J Electronic Schedule ZURICH IX,C 3329621-12 US@1J-1014 05(Ol!2015 -- -- o5.�OI&I4 2925,3000 --- Named Insarcnl and Mailing Address: Producer. CH2M Hill Companies, Ltd. Marsh USA, Inc. 9191 S Jamaica St 1225 17 ' St Ste #2100 Englewood CO 80112-5946 Denyer CO $0202.6521 THIS ENDORSEM-ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This andorsement modifies insurance prodded under the following Architecu- and Engineers Professional Liability Insurance Policy In umsidcralion of the premium already charged, we agree with you, subject to all terms, exclnsions, and conditions of the policy that A. If we cancel this policy by written ntttice w th;: first Named Insurt:d fur any reason other than nwipaymenl of premium, we will mail or deliver a copy of such wrillen naLice of iamcdlal61: 1. To Lhc name and address corresponding to each person or organisation shown in the Schedule provided to us by the lust "Named Insured". Such schedule: a. Must be initially provided to us within 15 days: (1) After the beginning of the policy period shown in the Declarations; or (2) After this endorsement has been added to the policy; It. Must contain the names and addresses of only the persons or organizations requiring notification that this Policy has bun cancelled; c. Must be in an electronic format that is acceptable to us; and it. Must be accurate. Such Schedule mnftt tx' updalLd and provided to as, by the first "Named Tosured", during the policy period Such updated Schedule must atmply with parugraphs b., c., and d above. 2. At (cast thirty (30) days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or - die longer number of days notice if indicated in die Schedule provided to us. B. Our notification, as described in Paragraph A. of this endorsement, will be based on the most recent Schedule proitided to us by the lust "Named Insured" as of the date the notice of cancellation is mailed. C. Proof of mailing will be sufficient proof that we have complied with Iaragraph A- of this endorsement. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the Schedule provide to us as described in Paragraphs A. of this endorsement, ALL OTHER /TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Signed By: %Y" .l l a 5/1,2014 4u rized Repi'esentatihre Date U-GL-113A CW (41M WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ENDORSEMENT If 006 This endorsement, effective 12:01 a.m.. May 01, 2014 forms a part of Policy No. RWD500025203 issued to CH2M HILL COMPANIES. LTD. by XL Insurance America, Inc. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 99 06 57 (Ed. 12/10) In the event coverage is cancelled or non renewed for any statutorily permitted reason, other than nonpayment of premium, or if there is a material reduction in coverage, advanced written notice will be mailed or emailed to person(s) or entity(ies) according to the notification schedule shown below: Name of Person(s) or Entity(ies): Mailing Address: Number of Days Advanced Notice: Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less 60 days than 15 days prior to the 60 days of notice of cancellation, non -renewal or material reduction in coverage. For the purpose of this endorsement, non -renewal shall mean solely non -renewal of the Policy and shall not include expiration or Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits, an increase in the deductible or self insured retention or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective May 01, 2014 Insured: CH2M HILL COMPANIES, LTD. XL Insurance America, Inc. Policy No. RWD500025203 Countersigned Endorsement No. WC 99 06 57 Ed. 12110 Oc 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Premium: Included