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HomeMy WebLinkAboutPARSONS BRINCKERHOFF INC - INSURANCE CERTIFICATEpRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/9/15 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 endorsementlsl. PRODUCER JLT Specialty Insurance Services Inc. 5847 San Felipe Street, Suite 2750 Houston, TX 77057 INSURED PARSONS BRINCKERHOFF, INC. 4139 Oregon Pike Ephrata, PA 17522 Jennifer Sprinkle E,ti; 713-325-7593 _ F(at. No): si wsppbcertreauesMiltus.com I wisuRER a: Zurich American Insurance Comoanv 1 16535 1 COVERAGES CERTIFICATE NUMBER: 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. — -- -- ._ Lnt TYPE OF INSURANCE '� L SUEOATPOLICY EFF POLICY EXP POLICY NUMBER YV LIMBS B X COMMERCIAL GENERAL LIABILITY GLO 9835819-02 4/1/2015 4/1/2016 EACH OCCURRENCE s2,000,000 `� 1� CWM6�AI X ADE OCCUR _DAMAGE TO RENT PREMISES (Ea giguirreno ------_--- 000,000 $ 5,000 �MED EXP (-Any one person) X Contractual Liability i $ 2,000,000 PERSONAL a_ADV INJURY GEKL AGGREGATE LIMIT APPLIES PER. $ 5,000,000 1 GENERAL AGGREGATE X POLICY E PRO- JECT LGC PRODUCTS - COMPIOP AGG $ 5A00,000 $ OTHER. A AUTOMOBILE LIABILITY AS7621094060024 10/1/2014 10/1/2015 CORD___ LIMIT (EaX s2,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per awidellQ PROPERTY DAMAGE , (Per accident) $ $ f UMBRELLA LM OCCUR EACH OCCURRENCE f AGGREGATE S EXCESS UAB CLAIMS -MADE'. DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY IN ANY PROPRIETORIPARTNER(EXECUTIVE Y� OFFICERBAEMBER EXCLUDED (Mandatory in NH) WA762 O94060014 (AOS) 7 1 4 10/11201 N/A WC+7621094060044 (WI) 10/1/2014 10/1/2015 TE _ M.LACCiDENT $1,000,000 $ 1,000,000 E_ - EA EMPLOYEE M yes descnbe under DESCRIPTION OF OPERATIONS below ' $ 1,000,000 E.L. DISEASE - POLICY LIMIT I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 131. Additional Remarks Schedule, may be attached if more space is required) (PB #A) FOR ADDITIONAL INFORMATION SEE PAGE 2 CITY OF FORT COLLINS RISK MANAGEMENT PO BOX 580 FORT COLLINS CO 80522 LRiUL9.3141 L111119101 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 Z 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ACORDs provided by Forms Boss www FormsBoss com, (c) Impressive Publishing 800-208-1977 AGENCY CUSTOMER ID: LOC #: ACORN® AnnITIONAI RFMARKS SCHFDLJLF Page__2__of 2 AGENCY JLT Specialty Insurance Services Inc. POLICY NUMBER Various CARRIER Various NAIC CODE NAMEDINSURED Parsons Brinckerhoff 4139 Oregon Pike Ephrata, PA 17522 EFFECTIVEDATE: Various ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (PB #A); CITY FORT COLLINS MIST - CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSURED AS RESPECTS TO GENERAL AND AUTO LIABILITY, AS REQUIRED BY WRITTEN CONTRACT. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD