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HomeMy WebLinkAbout453542 AECOM - INSURANCE CERTIFICATE'� 1 ® DATE (MA1/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE o3I20rz020 ��' - 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(Les) 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 f10437153 CONTACT _ NAME:. PHONE' FAX A/C No E-MAIL AD QREW 633 W. Fft Street, Suite 1200 Los Angeles, CA 90071 Attn: LosAngeles CeAReques@Marsh.Com INSURE S AFFORDING COVERAGE NAICS INSURER A: ACE American insurance Cornpany 22667 CN10134&%4-STND-GAUL-2D-21 Fort C GLALP 03 2020 INSUREDCOM Technical Services Inc. 1601 Prospect Parkway INSURER a :.NIA WA INSURER C: AIG Specialty Insurance Company 26883 INSURER D : SEE ACORD 101 Fort Collins, CO W525 INSURER E : ' INSURER F.: COVERAGES CERTIFICATE NUMBER, LOS-002123530.20 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 BY BY PAID CLAIMS. INSR LTR OF INSURANCE POOLTYPE INSO UB POUCYNUMBER MMIDOPOLICYYY M Wp LIMITS X COMMERCIAL GENERAL LIABILITY HDO G7123311A 04/01/2020 04/01/2021 EACH OCCURRENCE $ 1,000,0Do CLAIMS -MADE Fx-1 OCCUR DAMAGE TO RENTED PREMISES Esoccimence $ 1,00060 MED EXP (Any one awn) $ 5,000 _ PERSONAL a ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY ❑ JPERpT D LOC PRODUCTS-COMPIOPAGG $ 1,000,000 $ OTHER: - _ _ A AUTOMOBILE LIABILITY ISAR25301730 04/01/2020 D4101/2021 EaMBI a N=FSINGLELIMIT $ 1000000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHTOSEDULED U AUTOS ONLY ALIT HIRED NON-OYMED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Par. dent) $ $ UMBRELLA LUIB OCCUR EACH OCCURRENCE $. .AGGREGATE $ EXCESSUAB CLAIMS -MADE DED I I RETENTION $ - $. D WORRERSCOMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? ❑N (Mandatory in NH) NIA SEE ACORD 101 - 1 X I STAPER OTH- TUTE E E.L. EACH ACCIDENT $. 2,000,000 E.L. DISEASE -EA EMPLOYEE $ 2,000,000 EL DISEASE - POLICY LIMIT $. 2,000,000 U yye8sS describe.'umer DESCRIPTION' OF. OPERATIONS below C CONTRACTORS - - - CPL181416M 04/01/2620 04/01/2021 Per Loss/ Aggregate 4,000,000 POLLUTION LIABILITY ""CLAIMS -MADE"'" DEFENSE INCLUDED DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AMMO 101, Addleonal Remarfro SchedWe, may be attached If more space Is required) Re: Professional Services Agreement between The City of Fort Collins, Colorado and AECOM Technical Services, Inc. RFP 8047 Environmental Services. The City, its officers, agents and employees are named as additional insureds for GL 8 AL coverages, but only as respects work performed by or on behalf of the named insured. This insurance is primary and non- contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to the GL 8 AL coverages. The City of Fort Collins, Colorado P.O. BOX 580 FOR 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 Risk & Insurance Services James L. Vogel Ciro,, �— ACORD 25 (2016103) ©1 The ACORD name and logo are registered marks of ACORD T'ION. All rights AGENCY CUSTOMER ID: CNI O1348564 LOC #: Los.Angeles ACo ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh R sk & Insurance Services AECOM Technical Services Inc. 1601 prospect Parkway Fart Collins, CO 80525 POLICY NUMBER CARRIER NAIC CODE. EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insut Workers Compensation/Employer Liability cord. Policy Number Insurer States Covered WLR06692340A Indemnity Insurance Company of North America - NAIC # 43575 ADS WLR C6692332D ACE AEI Insurance Company - NAIC # 22667 CA, AZ, MA SCF C66923368 ACE American Insurance Company - NAIC # 22667 WI Rego Architects & Eng. Professional Liability, Carder. Illinois Union Insurance Company, NAIC 02790, Policy #: EON G21654693 005, Policy Term: 04I0112020 - 0410112021,'Claims Made; Defense Included, Limit$1,0110,000 Waiver of Subrogagon 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 it by written contrast ©2008 The ACORD name and logo are registered marks of:ACORD reserved. POLICY NUMBER: ISA H25301730 FORM MCS-90 Revised 0110512017 Endorsement Number, 43 ONIS Nua 2126-9008 Eapiratione 01/i112020 USDOT Number: Daze Received: A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person besubject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction. Act unless that collection of information displays a current - valid OMH Control Number. The OMB Control Number for this information collection is 2126-0003. Public reporting for this collection of information is estimated to be approximately 2 minutes per response, including the time for reviewing instructions, gathering time data needed, and completing and reviewing the collection of information. All responses to this collection of information are mandatory. Said comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Inforrnation Collection Clearance Officer, Federal Motor Carrier Safety Administration, MC-RRA, Washington, D.C..20590. a{,cult United States Department of T=A=w1n1s=rwU*n 1 Federat Mete1. r Curler safety 11 Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCSwVah0 Issued to AECOM of 9A (&doter Carrier rare) Datedat Wilmington, DE 19803 Amending Policy Number: ISA H25301730 (Motor Ci rner.rlate or province) onthis 16th day of March ., 20 20 Effective Date: 04/012020 Name oflnsurancecompany: ACE American Insurance Company Countersigned by: ere ee 1 uwxti n..�a. m (and1"zwd eoinpony repre rertaltm) The policy to which this endorsement is attached provides primary or excess insurance, as indicated for the limits shown (checkonly erne): aTrds nerevaae i, prmeary anllhe canparry steal! meat be hahk, jar mrorarls in excess qj'S 5. �0.000.,>Tx eacJi �eideeu ?7os. uurvmece is exce and the coryuM dealt nor be liable for smowih in excess of S _ for each accident in excess othh aredrr4 t rhau of $ - .... fry each accident Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company.agrees to furnish the FMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon.telephone request by an authorized representative of the FMCSA, to verify that the policy is in face as of a particular date. The telephone number to.call is. 215 - 640.- 4555 . Cancellation of this endorsement may be effected by the company or the insured by, giving (1) thirty-five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be sufficientproof of notice), and (2) if the insured is subject to the FMCSA's registration requirements under 49 U.S.C. 13901, by providing thirty (30) days notice to the FMCSA (said 30 days notice to commence from the date the notice is received by.the FMCSA at its office in Washington, DC). (continued on next page) FORM MCS-90 Page 1 of 3 MC1622u (01-177) Wolters Kluwer Financial Services, Inc. I Uniform Forms