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HomeMy WebLinkAboutGEOSYNTEC CONSULTANTS - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE DATE 3/24/2015vY) 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 Greyling Insurance Brokerage 3780 Mansell Road Suite 370 Alpharetta GA 30022 CONTACT Carl Underwood NAME: Y PHOAICNE (770)552-4225 A/� No): (866)550-4082 EIL .Carl underwood@ re lin A MADR Y• g Y 4com• INSURERS AFFORDING COVERAGE NAIC# INSURERA:National Union Fire Ins Co 19445 INSURED Geosyntec Consultants, Inc. 900 Broken Sound Parkway NW Suite 200 Boca Raton FL 33487 INSURER BiLiberty Insurance Corporation 42404 INSURERC:New Hampshire Insurance Company 23841 INSURERD AIG Specialty Insurance Company 26883 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 (Geosyntec Main) 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. INSR LTR OF INSURANCE ADDLTYPE INSR UBRPOLICY POLICY NUMBER MM ODIYYYY MMDDEXP YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occu..rce)$ 500,000 A I CLAIMS -MADE OCCUR 5302659 /1/2015 /1/2016 MED EXP(Any one person) $ 25,000 PERSONAL B ADV INJURY $ 1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accideritt $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED 6403892 (ADS) /1/2015 4/1/2016 A AUTOS UTO NON -OWNED 6403893 (CA) /1/2015 /1/2016 PROPERTY DAMAGE (Peraccident) $ HIREDAUTOS AUTOS X 4 UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 B EXCESS LAB CLAIMS -MADE DED I X I RETENTION$ 10,00 $ H7-651-291560-015 /1/2015 /1/2016 C WORKERS COMPENSATION 039901411 (ADS) /1/2015 /1/2016 X I TWO STATUCRY LIM - I DTH- ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 11000,000 A OFFICERIMEMBER EXCLUDED? IE (Mandatory in NH) N/A 039901412 (CA) /1/2015 /1/2016 E.L. DISEASE - EA EMPLOYEE $ 1,000,0001 E.L. D13HASE - POLICY LIMIT 1 $ 11000,000 If yes, describe under DFSCRIPTION OF OPERATIONS below I D Professional Liability I OPS 1951904 /1/2015 /1/2016 Per Claim $8, 000, 000 Contractors Poll. Liab. Aggregate $10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Re: Project - Baseline Evaluation of Groundwater Project. Completion Date: November 17, 2015. The City of Fort Collins, its officers, agents and employees are named as Additional Insureds with respects to General & Automobile Liability where required by written contract. The above referenced liability policies with the exception of professional liability are primary & non-contributory where required by written contract. Waiver of Subrogation is applicable where required by written contract & allowed by law. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, we will endeavor to provide 30 days' written notice (except 10 days for nonpayment of r F:PTIFIr:ATF wni r1FR r.ANr:F1 I ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchasing Dept. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 David Collings/CARLY ACORD 25 (2010/05) INS025 (201005) 01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS premium) to the Certificate Holder named below. OFREMARK COPYRIGHT 2000, AMS SERVICES INC.