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HomeMy WebLinkAbout100022 AECOM - INSURANCE CERTIFICATE (2)A� �® TY CERTIFICATE OF LIABILIINSURANCE DATE(AAADDDYVYY) 03/21/2020 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(ids) 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 endorsements . PRODUCER Marsh Risk 8 Insurance Services CA License #0437153 633 W. Fft Street, Suite 1200 Los Angeles, CA 9W71 CONTACT NAME: PHONE FAX No): E-MAIL ADDRESS: Attn:Le$Angeles.CartRequeSt@Marsh.Cgm INSURERS AFFORDING COVERAGE NAICn INSURER A: ACE American Insurance Company 22667 CN101348564-STND-GAUE-20-21 04 2019 INSAUERED INSURER B : N/A NIA INSURER C : Illinois Union Insurance Co 27960 URS Corporation 600 Montgomery Street, 26th Floor San Francisco, CA 94111 INSURER D : SEE ACORD 101 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER- LOS•002146994-26 RFVISIAN NIIMRFR- 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._ --MMIDD/YYYY INSR LTR TYPE OF INSURANCE ADDL USR POLICY NUMBER POLICY EFF POLICY EXP MM/DDNM, LIMITS A X COMMERCIAL GENERAL LIABILITY HDO G7123311A 04/0112020 04/01/.2021 EACH OCCURRENCE $ 2,600,000 CLAIMS -MADE a OCCUR PREMISE Ea occurrence 3 1,000,000 MED EXP (Any one Person) S 5,000 PERSONAL a ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 1:1PRO JECT PRODUCTS -COMOP AGG 2,000,000 $POLICY 1 $ OTHER: A AUTOMO&LELIABILRY ISAH25301730 04101/2020 OVO1/2021 COMBINED SINGLE LIMIT accident $ 2,000,000Ee X BODILY INJURY (Par person) _ $ ANY AUTO OWNED OSCHEDULED AUTOS ONLY AUTS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED?- 1 (Mandatory In NH) N/A SEE ACORD 101 X I PER DTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE -EA EMPLOYEE $ 2,000,000 H yes, describe under below2,000,000 DESCRIPTION OF OPERATIONS E.L. DISEASE - POLICY LIMIT $ C ARCHITECTS 8 ENG. EON G21654693 005 04/01/2020 04/01/2021 Per CWrrVAgg 1,000,000 PROFESSIONAL LIAB. "CLAIMS MADE" Defense Included DE - - --- - DESCRIPTION OF OPERATIONS / LOCATKINS VEHICLES(ACO--RD 101,_ Addl-_tlona-l- Ramada Schedule, may - be altechetl If more apace b requhed) RE: Project No.: 22236040 - Dry Creek Basin Flood Control Project City of Fort Collins 215 North Mason_ Street 2nd Floor PO Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORGMD REPRESENTATIVE of Marsh Risk S Insurance Services James L. Vogel ACORD 25 (201610.3) © 1988-2016 The ACORD name and logo are registered marks of ACORD All rights reserved. AGENCY CUSTOMER ID: CN101348564 LOC #: Los Angeles ADDITIONAL REMARKS SCHEDULE Page 2_ of 2 Marsh Risk & Insurance Services "C"""' URS Corporation PoucY NUMBER 600 Montgomery Street, 26th Floor San Francisco, CA 94111 CARRIER Naic coot_ _ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation/Employer Liability Cont. Policy Number Insurer States Covered WLR C6692340A Indemnity Insurance Company of North America - NAIC If 43575 AOS WLR C66923320 ACE American Insurance Company - NAIC If 22667 CA, AZ, MA SCF C66923368 ACE American Insurance Company - NAIC # 22667 WI Retm Waiver of Subrogation is applicable where required by written contract with respect to WC. If the insurer for the Workers Compensation policy cancels its policy for any reason other than for non-payment of premium, the insurer will provide 30 days notice of cancellation to those Certificate Holders that require k by written contract. reserved. The ACORD name and logo are registered marks of ACORD