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Home My WebLink AboutAECOM TECHNOLOGY CORPORATION - INSURANCE CERTIFICATEACORbr CERTIFICATE OF LIABILITY INSURANCE llia� I/l/2016 DATE(MNUDD/YYYY) 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 time not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Insurance Brokers, LLC 725 S. Figueroa Street, 35th Fl. CA License #01715767 Los Artgeles CA 90017 (213)689-0065 CONTACT INC,No Eat): FAX No EMAIL AD INSURERISI AFFORDINGCOVE 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: INSURER C: INSURER IN INSURER COVERAGES AFCTF.01 CERTIFICATE NUMBER: 1121RI94 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPETHISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDIEINSD SUER WVD POLICY NUMBER POLICY EFF POLICY EXPLIMITCOMMERCIAL GENERAL LIABILITY ❑ OCCUR NOT APPLICABLE EACH OCCURRENCE WPOLICYRIODINDICATED. XCLAIMS-MADE PRA MG ET RENTED XMED EXP An one rson XPERSONAL a ADV INJURY X GENL AGGREGATE LIMIT APPLIES PER POLICY JE& 7LOC OTHER GENERAL AGGREGATE $ XXXXXXX PRODUCTS- COMPIOP AGG$ XXXXXXX $ AUTOMOBILE LIABILITY ANY AUTO AUTOWNED SCHEDULED HIRED AUTOS NONSWNED NO'I'APPI.ICABLE COMBINED SINGLE LIMIT aaccident XX $ XXXXX BODILY INJURY (Per Person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX RarrarE.ciden DAMAGE $ XXXXXXX UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX DIED I I RETENTION $ $ %t WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN OFFICER/MEM ER EARTNER t ECUrIVE � (Mandatory in NH) It yes, descnue umer DESCRIPTION OF OPERATIONS cel. N I A N SEEATTACHEDACORD101 1/1/2015 I/l/2016 PER OTH- X STATUTE FR E.L. EACH ACCIDENT $ 10,000,000 EL DISEASE - EA EMPLOYEE 10000000 E.L. DISEASE -POLICY LIMIT 10000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if mum space is required) Notice of Cancellation applies per attached endorsement. Evidence of Insurance Lot- K 111• IUA I t HULUtK L;A1NUt=LLAI RUN aCC Attacnments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 13238194 AUTHORIZED REPRESENTATIVE Cityy of Fort Collins 215 North Mason Street 2nd Floor P.O. Box 580 Fort Collins CO 80522-0580 USA ACORD 25 (2014/01) 919%8-201"CORD CORPORATION. All rights 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, 011, WA, and WY Workers' Compensation coverage is provided by the State Fund. In those States, the above reference policies provide Stop -Gap Employers' Liability only. Workers' Compensation policies apply as indicated below: AECON1'I'cchnology Corporauon WC 028328280-CA WC 028328281 - FL \1 C 028328282- MA,ND,01 1,\\'A,\\'I,\\Y WC 028328283-ME \C'C 028328284-AK,AZ,VA \VC 028328285- II,KY,NC,N14,U'1',VI' WC 028328286 - NJ, PA WC 028328287-AI.,AR,CO3CI',DC,DE,GA,HI,ITID,IN,KS,LA,MD,NII,NIN,N1QMs,NrI'NE,NM,NV,NY,OK,OR,RISC$D;IN;IX,\\V URS Corporation WC 028328288 - CA WC 028328289- FL WC 028328290 - NIA,ND,Oi [,\VA Wl,\Y WC 028328291-AI.,AR,CO3CI',UC,1)E,GA,111,IA,ID,IN,KS,1$MD,MI,MN,M0,MS,Nf1',NE,NM,NV,NY,OK,OR,RI,SC,SD;IN;IX,\VV WC 028328292- IL,KY,NC,NIi,U'1',VI' WC 028328293 - NJ,PA \VC 028328294 - AK,AZ,VA \VC 028328295-ME ACORD 101 Miscellaneous Attachment : M503712 Master ID: 1389302, Certificate ID: 13238194 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). 'Phis endorsement, effective 1201 AI 11/1/2015 forms a pan of Policy No. SN.'. ATI'ACfIED ACORD 101 Issued to AliCOM Technology Corporation URS 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(,) when this policy is canceled (hereinafter, the "Certificate I{older(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 liolder(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 -[older(,,) as soon as reasonably practicable after the Named Insured confirms the accuracy of the Schedule below with the Insurer. proof of the Insurer emailing 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. This 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: 13238194