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HomeMy WebLinkAbout465997 MICHAEL BAKER JR INC - INSURANCE CERTIFICATE (6)CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDMYY) a7roBrzo14 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 pollcy(les) most 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 andomement(s). PRODUCER AOn Risk Services Central, Inc. Pittsburgh PA office CONTACT NAME: PH NE FAX UVc.No. ea): (666) 283-]122 = No.): (800) 363-0I05 Dominion Tower, loth Floor 625 Liberty Avenue EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICM Pittsburgh PA 15222-3110 USA INSURED INSURER A: National Fire Ins CO of Pittsburgh 19445 Michael Baker 3r.. Inc. LakewoodS. union 02Vd, SUI Le 200 1 �`C Lakco 80228 USA mutual INSURER B: Liberty MULUaI Fire Ins CO 23035 2303S INSURER C: Lloyd's syndicate No. 2623 y y AA1128623 INSURER D: Liberty Insurance Corporation 42404 E: INSURER F: U'VViKAoia L.CK I IrIUA 1 L NVINIUMM 01 UUD WJVOO KtVI51UN NUMBtK' 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 INSD VND POLICY NUMBER MM/D MMID LIMITS B X COMMERCIALGENERALLWBIUTY TB EACH OCCURRENCE S2,000,000 CIAIMS-WDE ❑X OCCUR PREMISES Ea oavrmnos S1,000,000 MED EXP (Any one Person) $5 , 000 PERSONAL& ADV INJURY S2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $4,000,000 POLICY ❑JET ❑X LOG PRODUCTS-COMP/OPAGG $4,000,000 OTHER: B AUTOMOBILE UA81UW A52-681-004145-724 06/30/201408/30/2015 COMBINED SINGLE LIMIT " e ..dgro $1,000,000 ' BODILY INJURY( Per Person) X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per acdoen0 PROPERTY DAMAGE Per eocident A X UMBRELLALUI9 OCCUR BE018085867 06/30/2013 O8/30/2014 EACH OCCURRENCE 510,000,000 EXCESS LIAR H CLAIMS -MADE AGGREGATE S10,000,000 DED I X IRETENTION S10. 000 D O WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR I PARTNER I'CULIVE OFFICEIUMEMBER EXCLUDED? H NIA WA768DO04145694 ADS wC7681004145704 06 30 2014 O6/30/2014 08 30/2015 08/30/2015 PER OTH- X STATUTE E.L EACH ACCIDENT S1,000,000 E.L. DISEASE -EA EMPLOYEE S1,000,000 (Man4abry in NH) If yea, Eeacros unam DESCRIPTION OF OPERATIONS"10o wI EL DISEASE -POLICY LIMIT S110001000. C E&O-PL-Primary OC1402675 06/30/2014 08/31/2015 Per Claim f5,000,000 Professional & Pollution Aggregate S5,000,000� SIR applies per policy ter is & conditions DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101, AaGPoonal Remarks Schedule, may W sea.M R mom µwee is reauhad) 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 policies, per written contract with the Named Insured. 1 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 MCQuilki0 AUTHORIZED REPRESENTATIVE PO BOX 580 Fort Collins11 CO $0522 USA re 0 m 0 0 H 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD