HomeMy WebLinkAbout150670 STANTEC CONSULTING SERVICES INC - INSURANCE CERTIFICATE (17)AcoRo° CERTIFICATE OF LIABILITY INSURANCE 5/1/2020
DATE(MM/DD/YYYY)
1 4/18/2019
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 INSURERS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 LOCKTON COMPANIES
CONTACT
NAME:
444 W. 47TH STREET, SUITE 900
KANSAS CITY MO 64112-1906
(816)960-9000
A/c,NFNo, FAX
Ext : AIC, No
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A : Berkshire Hathaway Specialty Insurance Company
')2276
INSURED STANTEC CONSULTING SERVICES INC.
INSURER B: Travelers property Casualty Cc otAmerica
25674
1426517 370 INTERLOCKEN BOULEVARD, SUITE 300
BROOMFIELD CO 80021-8012
INSURER C :
INSURER D :
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 14564636 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
N
N
47-GLO-307584
5/1/2019
5/1/2020
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
1,000,000
X
MED EXP (Any oneperson)
$ 25 000
CONTRACTUAL/CROSS
X
XCU COVERED
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- FX LOC
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
B
B
B
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
N
TC2J-CAP-8E086819
TJ-BAP-8E086820
TC2J-CAP-8E087017
5/1/2019
5/1/2019
5/1/2019
5/1/2020
5/l/2020
5/1/2020
EOa COMBINEDSINGLELIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$XXXXXXX
PROPERTY DAMAGE
Per accident
$ XXXXXXX
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$XXXXXXX
A
X
UMBRELLA LIAB
X
OCCUR
Y
N
47-UMO-307585
5/1/2019
5/1/2020
EACH OCCURRENCE
$ 5,000,000
X
AGGREGATE
$ 5,000,000
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$ XXXXXXX
B
B
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? FNI
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
TC2J-UB-8E08592 (AOS)
TRJ-UB-8E08593 (MA, WI)
EXCEPT FOR OH ND WA WY
5/1/2019
5/1/2019
5/1/2020
5/1/2020
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
Ir, 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
FORT COLLINS, CO. STANTEC PROJECT # 1873. RE: 5-YR OPEN ENDED CONTRACT. THE CITY OF FORT COLLINS, ITS OFFICERS,
AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS WITH RESPECTS TO THE GENERAL LIABILITY, AUTO LIABILITY
AND UMBRELLA/EXCESS LIABILITY, BUT ONLY ARISING OUT OF OPERATIONS OF THE NAMED INSURED, IF REQUIRED BY WRITTEN
CONTRACT. THE COVERAGE SHALL NOT BE CANCELLED EXCEPT AFTER THIRTY (30) DAYS WRITTEN NOTICE TO THE CERTIFICATE
HOLDER.
CERTIFICATE HOLDER CANCELLATION
14564636
CITY OF FORT COLLINS
ATTN: PURCHASING
P.O. BOX 580
FORT COLLINS CO 80522
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 REPRESENTATIVE
ACORD 25/2016/031
n 19$5-2015 ACORD CORPORATION_ All riahts reserved
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