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HomeMy WebLinkAbout453542 AECOM - INSURANCE CERTIFICATE (2)A C® ® ��.=. CERTIFICATE OF LIABILITY INSURANCE DATE(MNVdc)IY Y) 03119n020 IS ISSUED AS A MATTER OF INFORMATION ONLY Ago CONFERS WRIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND; EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED BELOW. THIS CERTIFICATE 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 CONTACT NAME: James Vogel Marsh Risk & Insurance Services PHONE 213-346.5098 a No : 212-948-0533 Elfil CA License #0437153 633 W. Fifth Street, Suite 1200 EMAIL ADDRE : James.lyogel@marsh.com INSURER(S) S AFFORDING COVERAGE NAIL C Los Angeles, CA 90071 Attn: LosAngeles.CertRequest@Marsh.Com 22667 CN101348%4-PROJ-GAUE-20-21 Denver CO 04 2019 INSURER A: ACE American Insurance CoMany INSURED . INSURER B : WA WA INSURER C : WA WA AECOM AECOM Technical Services, Inc. INSURER D ::SEE ACORD 101 EDAW, Inc INSURER E : 71717th Street, Suite 2600 Denver, CO 80202 INSURER F : COVERAGES _.,_ --------- __ _ . -_ _ -_ _ _ 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 DO¢UMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, _.. ILTR A _._._ _._ . TYPE OF INSURANCE X COMMERCIAL GENERALLL1e1LITY A OL SUB POLICY NUMBER HDOG7123311A POLICY EFF MMIDD/YYY 04101/2020 PM1DD/Y EXP.LIMITS MM/DD/YYYY 04/0112021 EACH OCCURRENCE ' _ $ 1000,000 PREMISEST ORE NTED fEa occurrence $ 1,00,000 CLAIMS -MADE O OCCUR MED EXP (An one Person)$ 5 ,000 .PERSONAL & ADV INJURY $ 1'000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY El PRO-JECT LOC PRODUCTS_ COMP/OP AGG $ 1,000,000 A OTHER: AUT6LAOBILELNIBILITV ISAH25301730 04/01/2020 04101/2021 OM(EaBIINEDSINGLELIMIT am $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED-SCHEDtII ED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per acnidem $ ��J $ UMBRELLA LIAS OCCUR EACH OCCURRENCE. $ AGGREGATE $ EXCESS LUIB CLAIMS -MADE D SEE ACORD 101 X STATUTE ER $ DED .RETENTION$ WORKERS COMPENSATION E.L. EACH ACCIDENT $ 2,000,000 AND EMPLOYERS LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECU I IVE OFFICER/MEMBER EXCLUDED? O (Mandatory In NH) If yea, describe under DESCRIPTION OF OPERATIONS below N/A E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Ramada Schedule, may be attached N more apace Is required) RE: Mason Project. THE CITY OF FORT COLONS, ITS OFFICERS, AGENTS, AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED FOR GL & AL COVERAGES, BUT ONLY AS RESPECTS WORK PERFORMED BY OR Ol, BEHALF OF THE NAMED INSURED. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P.O. Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS.. of Marsh Risk & Insurance Services James L. Vogel �—rani—erg I ©1988-2016 ACORD CORPORATION. All ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101348564 LOC #: Los Angeles ACo d ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED - Marsh Risk 8 Insurance Services AECOM AECOM Technical Services, Inc. EDAW,Inc. vouaY46FNIB R 71717th Street, Suite 2600 Denver; CO 10202 CARRIER NAIC CODE EFFECTIVE DATE: ITHIS ADDITIONAL, REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE_:- Certificate of Liability Insurance Workers CompensabonlEmployer Liability Cont. Policy Number Insurer States Covered WLR 06692340A Indemnity Insurance Company of North America - NAIC # 43675 AOS WLR 066923320 ACE American Insurance Company - NAIC # 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 it by mitten contract. 101 120091011 The ACORD name and Logo are registered marks of ACORD CORPORATION. All rights reserved.