HomeMy WebLinkAbout214608 ATKINS NORTH AMERICA INC - INSURANCE CERTIFICATE (6)ACORD CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
10115/2019
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 INSURER(S), 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 ri hts to the certificate holder in lieu of such endorsement(s).
PRODUCER - -
MARSH USA, INC.
TWO ALLIANCE CENTER
3560 LENOX ROAD, SUITE 2400
ATLANTA, GA 30326
NTACT - --
NAME.
PHONE FAX
ac No
E-MAIL
ADDRESS:
INSURER S AFFORDING COVERAGE
NAIC p
INSURER A: Zurich American Insurance Company
16535
CN102421774-Atkin-GAWUp-19-20
INSURED Atkins North America, Inc.
INSURER B : American Guarantee & LiabilityIns Co
26247
4036 West Boy Scout BlVd. Ste. 700
INSURER C :
INSURER D
Tampa, FIL 33607-5713
.INSURER E
F :.-
..INSURER
n^%i An_ee reoTICICATF kit HU1000• ATI-004778966-06 REVISION NUMBLK: U
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
ADDLISUOR
-
POLICYNUMBER
POLICY EFF
MMIDD/YYYY
.POLICY EXP
MMIDDIYYYY-
LIMITS
A
X
COMMERCUILGENERALLIABRITY
GLO0137576-05
10/1512019
1011512020
EACH OCCURRENCE
$ 2,ODO,000
CLAIMS -MADE OCCUR
DAMA ED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 60,000
PERSONAL a ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS - COMPIOP. AGG
$ 4,000,000
X PRO ❑ LOC
POLICY ❑ JECT
OTHER. -
- - _
A
AUTOMOBILEUABILIT-Y
BAP013757505
10/15/2019
10/1512020
Ee BINEDtSINGLELIMIT
$ 2,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
BODILY INJURY (Per amident)
It
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
ONLY AUTOS ONLY
PROPERTYDAMAGE
$ $AUTOS
X
UMBRELLA LIAB
X
OCCUR
AUC 9304209.51
1011512019
10115/2020
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
EXCESS UAB
CLAIMS -MADE
DED RETENTION $
$
A
WORKERS COMPENSATION
WC013757705
-
11111512020
X STATUTE ERN
- _ _
AND EMPLOYERS' LUU3ILITY YIN
ANYPROPRIETORIPARTNEPJEXECUTIVE
OFFICER/MEMBEREXCLUDED? FINNI'4
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below-T
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ _ 1,000,000
I
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required)
RE: 7307 Transportation Planning & Engineering Consultant On -Call - Purchase Order: 9117628 for. Work Order 901003-01-11
City of Fort Collinsis included as addilional insured with respect to General Liability and Auto Liability where required by written contract.
I
City of Fort Collins
Attn: James O'Neill
215 N. Mason Street, 2nd Floor
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.
of Marsh USA Inc.
Manashi Mukherjee ,.Mauoo"
6 ACORD CORPORATION: All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD