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Home My WebLink About100022 AECOM TECHNICAL SERVICES INC - INSURANCE CERTIFICATE (12)ACOR& CERTIFICATE OF LIABILITY INSURANCE `i 1/1/2016 DATE(MMIDDIYYYY) 1 12/4/2014 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 terns 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 Insurance Brokers, LLC 725 S. Figueroa Street, 35th FI. CA License tlOF15767 Los Angeles CA 90017 (213)68M065 CONTACT NAME: PHONE INCNa Eat): we ND E-MAIL ADDRESS, INSUREFUSI AFFORDINGCOVERAGE NAICa INSURER A: Insurance Company of the State of PA 19429 INSURED AECOM Technology Corporation 1389302 URS Corporation 600 Montgomery Street, 26th Floor San Francisco CA 94111 INSURER B : INSURERC: INSURER D N E N R F COVERAGES AECTE01 CERTIFICATE NUMBER: 13238193 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. ILTR TYPE OF INSURANCE ADDL $UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LABILITY CLAIMS -MADE ❑ OCCUR NOT APPLICABLE EACH OCCURRENCE IS XXXXXXX DAMAGE TO RENTED PREMISESEa occurrersi XXXXXXX MED EXP (Any one arson XXXXXXX PERSONAL It ADV INJURY S XXXXXXX GEN'L AGGREGATE LIMIT APPLIES PER POLICVF—]JE� F__]LOC OTHER GENERAL AGGREGATE $ XXXXXXX PRODUCTS - COMPIOP AGG $ XXXXXXX $ AUTOMOBILE LABILITY ANY AUTO AUTOWNED SCHEDULED HIRED AUTOS NON -OWNED NOT APPLICABLE FO COMBINED SINGLE LIMIT $XXXXXXX BODILY INJURY (Per Person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY Pr wdn $ XXXXXXX $ UMBRELLA LAB A EXCESS LB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXJOC DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLO ERTLABILITY YIN OFFIDEOPRIE ERPXRTNE ECUrIVE � (Mandatory in NH) If yes. deedd,e uMer DESCRIPTION OF OPERATIONS Eel. N/A N SEE ATTACHED ACORD 101 1/1/2015 1/1/2016 ER X STATUTE FR E.L. EACH ACCIDENT $ 10000000 E L DISEASE- EA EMPLOYEE 10,000,000 EL DISEASE - POLICY LIMIT t 10000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark, Schedule, may be attached If more space is required) Notice of Cancellation applies per attached endorsement. Evidence of Insurance CEK IIHICA I E HULUEK CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 13238193 AUTHORIZED REPRESENTATIVE City of Fort Collins Attn: Opal Dick 215 North Mason Street, 2nd Floor P.O. Box 580 Fort CollinsC080522-0580 USA ACORD 25 (2014/01) 01 8-201 C D CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD Insurer A:'Ihe Insurance Company of the State of Pennsylvania The Workers' Compensation coverage shown does not apply in monopolistic states. In the State of ND, 0I1, WA, and WY Workers' Compensation coverage is provided by the State Fund. In those States, the above reference policies provide Stop -Gap Emploverc' Liability only. Workers' Compensation policies apply as indicated below: AECOM Tcehnnlogy Corpocoi.n WC 028328280-CA WC 028328281- FI. \VC 028328282-MA,ND,01 J,\VA,\VI\CY WC 028328283- ME WC 028328284 - AK,AZ,VA WC 028328285-II„KY,NC,NH,UT,VT WC 028328286 - NJ, PA WC 028328287-AL,AR,CO3CT,DC,DE,GA,HI,IA,ID,IN,KS,I.A,MD,MI,MN,M0,MS,MINE,NM,NV,NY,OK,OR,RI,SC,SD,TN,TX}CN URS Corp,tau"a WC 028328288 WC 028328289 WC 028328290 WC 028328291 WC 028328292 WC 028328293 WC 028328294 WC 028328295 ACORD 101 CA FL MA,ND,OH,R'A R9\VY AI ,AR,CO,CT,DC,DP OAJiI,IA,ID,i N,K.S,IA,MD,MI,MN,MO,MS,MT,NF, NM,N V,NY,OK,OR RI,SC,SD;INIX \CN IL,KY,NC,NH,UT,VT NJPA AK,AZ,VA ME Miscellaneous Attachment : M503712 Master ID: 1389302, Certificate ID: 13238193 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 ANI 1/l/2015 forms a part of Policy No. SEE A'ITACHI3D ACORD 101 Issued to AI3COM'1'echnology Corporation UItS Corporation Hy The Insurance Company of the State of Pennsylvania LIMITED ADVICE OF CANCELLATION TO SCHEDULED ENTITIES (WORKERS' COMPENSATION ONLY) this policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an existing contractual obligation to notify a certificate holder(s) when this policy is canceled (hereinafter, the "Certificate I-Iolder(s)") and the Named Insured has provided the Insurer, either directly or through its broker of record, either: (a) the name of the entity shown on the certificate, a contact name at such entity and the U.S. Postal Service mailing address of each such entity; or (b) the email address of a contact at each such entity; and 3. prior to the effective date of cancellation, the Named Insured confirms to the Insurer, either directly or through its broker of record, that the persons or organizations set forth in the Schedule below, as well as their respective addresses listed, should continue to be a part of the Schedule and, if not, the names of the persons or organizations that should be deleted, the Insurer will provide advice of cancellation (the "Advice") to each such Certificate I lolder(s) confirmed by the Named Insured in writing to be correctly a part of the Schedule within days after the Named Insured confirms the accuracy of the Schedule below with the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate I lolder(s) as soon as reasonably practicable after the Named Insured confirms the accuracy of the Schedule below with the Insurer. Proof of the Insurer entailing the Advice, using the information provided and subsequently confirmed by the Named Insured in writing, will serve as proof that the Insurer has fully satisfied its obligations under this endorscmcnt. 'Phis endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following definitions apply to this endorsement 1. Named Insured means the first named employer in Item 1 of the Information Page of this policy. 2. Insurer means the insurance company shown in the header on the Information Page of this policy. WC 99 00 58 (Ed. 04/11) Attachment Code: D503695 Master ID: 1389302, Certificate ID: 13238193