HomeMy WebLinkAbout453542 AECOM - INSURANCE CERTIFICATE (4)a
A�/R® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMDDIYYYY)
03/21/2020
THIS CERTIFICATE IS ISSUED AS A MATTER 60 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(fes) 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 end orsemen s ..
-
PRODUCER
CONTACT
NAME:
Marst Risk & Insurance Services
PHONE FAX
CA License #0437153
A/CNo
E-MAIL
ADDRESS:
633 W. Fifth Street, Suite 1200
Los Angeles, CA 90071
Attn: LosAngeles.CertRequest@Marsh.Com
INSURFRISI AFFORDING COVERAGE
NAIC d
INSURER A: ACE American Insurance Company
22667
CN101348564STND-GAUE-20-21 02 2023
INSURED.
INSURER B : WA
N/A
AECOM
AECOM Technical Services Inc.
INSURER C : Illinois Union Insurance Co.
279so
INSURER D : SEE ACORD-101
1601 Prospect Parkway
Fort Collins, CO 80525
INSURER E
INSURER F
^=nn 10K^AT WINUIMMO• Il1.Gfln'l:1Ki111M11K KFVINIUN Nl1MtlGK_
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 HAVEBEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OFINSURANCE
AD L
vmn UBR
POLICY NUMBER
MNNDYIYYYY
MMDDAMY
LIMITS
A
X
COMMERCIALGENERALLUI'&UTY
HDOG7123311A
04/0112020
04/0112021
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE T OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 5,000
PERSONAL d ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
X POLICY ❑ PRO ❑ LOC
JECT
OTHER:
A
AUTOMOBILE LIABILITY
ISA H25301730
04/01/2020
04/01/2021
Ee aBBIINEEDntSINGLE LIMIT
g 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED RETENTION
$
D
WORKERS COMPENSATION.
_ _
SEE ACORD 101
120 1
X STATUTE ERH
E.L. EACH ACCIDENT
$ 1 OD,000
AND EMPLOYERS LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? �
(Mandatory in NHS
if yyes, dascnbe under
OESCRIPTION OF OPERATIONS bebw
NIA
-
E.L. DISEASE - EA EMPLOYEE
$ 100,000
E.L. DtSFASE -POLICY LIMIT
$ 500,000
C
ARCHITECTS 8 ENG.
EON G21654693 005
04/01/2020
04/01/2021
Per Claim/Agg
1,000,000
PROFESSIONAL LIAB.
'CLAIMS MADE'
Defense Included
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required)
Re: Professional Services Agreement - General Environmental Services
The City of Fort Collins, its officers, agents and employees are named as additional insured for GL 8 AL coverages, but only as respects work performed by or on behalf of the named insured and where required by
written contract.
City of Fort Collins
Attn: Pal Johnson, CPPB, Senior Buyer
215 N. Mason Street, 2nd Floor
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REF
of Marsh Risk 81
James L. Vogel1vfr.
ACORD 25'(2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: CN101348564 _
LOC #: Los Angeles
A4 R
16. . _
ADDITIONAL REMARKS SCHEDULE
Page 2 of 2
AGENCY
NAKED INSURED
Marsh Risk 8 Insurance Services
AECOM
-
AECOM Technical Services Inc.
1601 Prospect Parkway
POUCY NUMBER
Fort Collins, CO 80525
CARRIER
NAIC CODE
EFFECTIVE DATE:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
Workers CompensaboNEmployer Liability cant.
Policy Number
Insurer
States Covered
WLR C6692340A
Indemnity Insurance Company of North America - NAIC # 43575
AOS
WLR C66923320
ACE American Insurance Company - NAIC # 22667
CA, AZ, MA
SCF C66923368
ACE American Insurance Company - NAIC # 22667
WI Retro
ACORD 101 (2008101)
The ACORD name and logo are registered marks of ACORD
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