HomeMy WebLinkAbout310503 ECONOMIC & PLANNING SYSTEMS - INSURANCE CERTIFICATE (7),d►oRD® CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDIYYYY)
3/12/2020
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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln 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
Andreini & Company -San Mateo
220 West 20th Ave
San Mateo CA 94403
CUKTACT NAME: Kelly Totten
PHONE FAX
• 650-378-4322 A/c No:650-378.436T
EMAIL - ___
ADDRESS: ktotten andreini.com
INSURE S AFFORDING COVERAGE.
NAIC0
INSURERA: Federal Insurance Company
20281
INSURED ECONO.5
INSURER a: Republic Indemnily Cc of Calif
43753
Economic .& Planning Systems
400 Capitol Mall, 28th Floor
INSURERc: Continental Casualty Company
20443
INSURER D:
Sacramento CA 95814
INSURER E
INSURER F.:
COVERAGES CERTIFICATE NUMBER:1880674265 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 BEEN REDUCED BY PAID CLAIMS.
IT
TYPEOFINSURANCE
L
IN D
WVD
POUCYNUMBER
POLICY
WDOMY
DmYLR
M/D
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
V
35929623WCE
4/1/2D20
4/1/2021
EACHOCCURRENCE
$1,000.000
CLAIMS -MADE I A I OCCUR
PREMISES Ea occurrence
$1,000,000
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$ see Insurer C
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$3,000,000
RXPOLICY E] JEC [:] LOC
PRODUCTS - COMP/OP AGG
$ 3.000,000
Per PreectA
$3,000,000
OTHER: Per.Proect/Loc
A
AUTOMOBILE LIABILITY
Y
Y
73558746
4/1/2D20
4/1/2021
OMacBINED SINGLE LIMIT
Ea cdent
$1,000,000
BODILY INJURY (Per.person)
$
AUTO
IANY
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
Per accidem
$
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
A
X
UMBRELLA LIAB
X
OCCUR
79871994
411/20,20
411/2021
EACHOCCURRENCE
$1,000,000
X
AGGREGATE
$1,000,000
Excess LIAB
CLAIMS -MADE
DED I X I RETENTION S.n
$.
B
WORKERSCOMPENSATION
AND EMPLOYERS'LWBILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
Y
16150817
4/1/2020
4/1/2021
X STgTUTE ERH
E.L. EACH ACCIDENT
$1,000,000
OFFICERIMEMBEREXCLUDED7
N / A
(Mandatory In NM
E.L. DISEASE - EA EMPLOYEE
$1,000,000
II yes. describe under
DESCRIPTION OF: OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1,000,000
C
Erron& Omissions
Adv/Personal Injury
425343942
-
4/1/2020
-
4/1/2021
Par Claim
Annual Aggregate.
2,000,000
2,000,000
Retro IIV83 Retention - $10,000
DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, AddlKor el.Remarks Schedule, may be attached It more apace Is required)
30 days notice of cancellation except 10 days for non-payment of premium per policy provisions.
EPS #: 183024
City of Fort Collins its officers, agents, and employees are additional insured on a primary and non-contributory basis with regard to General and Auto Liability
and Waivers of Subrogation apply per attached policy provisions.
30 days notice of cancellation except 10 days for non-payment of premium per policy provisions.
SHOULD ANY OF THE ABOVEDESCRIBEDPOLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Jerri Groves ACCORDANCE Ill THE POLICY PROVISIONS.
Purchasing Dept.
215 North Mason Street AUTHORIZED REPRESENTATIVE
Fort Collins CO 80524
USA
ACORD 25 (2016103)
The ACORD name and logo are registered marks of ACORD
2 of 10 767
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313
(Ed. 04-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that
you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or, indirectly to benefit anyone not named in the Schedule.
Schedule
State Person or Organization Job Description
Colorado
This endorsement provides a blanket waiver of subrogation applicable to all jobs for persons or organizations
whom the Named Insured has agreed by written contract to furnish this waiver. The charge for this endorsement
shall be 2% of total manual premium, subject to a minimum premium of $100. This charge will be billed on your
next invoice based on current manual premium, and the final charge will be calculated And billed at the final
audit.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
Republic Indemnity Company of California
Company Number
27561
Insured
Economic and Planning Systems, Inc.
Policy Number
161508-17
Endorsement Number
7
Endorsement Effective
April 01, 2020
Printed On
March 09, 2020
Countersigned by
WC000313
(Ed. 04-84)
01983 National Council on Compensation Insurance.
Insured Copy
3 of 10 767
C H U S ®0 Liability Insurance
Endorsement
Policy Period APRIL 1, 2020 TO APRIL 1, 2021
Effective Date APRIL 1. 2020
Policy Number 3592-96-23 WCE
Insured ECONOMIC & PLANNING SYSTEMS INC
Name of Company FEDERAL INSURANCE COMPANY
Date Issued JANUARY 15, 2020
Who Is An Insured
Additional insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are
Scheduled Person obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by
Or Organization this policy.
However, the person or organization is an iffiured only:
• if and then only to the extent the person or organization is described in the Schedule,
• to the extent such contract or agreement requires the person or organization to be afforded
status as an insured;
• for activities that did not occur; in whole or in part, before the execution of the contract or
agreement; and
• with respect to damages, loss, cost or expense for injury or damage to which this insurance
applies.
No person or organization is an insured under this provision:
• that is more specifically identified under any other provision of the Who Is An Insured
section (regardless of any limitation applicable thereto).
• with respect to any assumption of liability (of another person or organization) by them in: a
contract or agreement. This limitation does not apply to the liability for damages, loss, cost or
expense for injury or damage, to which this insurance applies, that the person or organization
would have in the absence of such contract or agreement.
Liability Insurance Addiffonal Inured - Scheduled Peraon Or organization continued
Form 60-02.2367 (Rev.5-07) Endorsement Page t
7 of 10 767
C ICI U B B°
Liability Endorsement
(continued)
Under Conditions, the following provision is added to the condition titled Other Insurance.
Conditions
Other Insurance — If you are obligated, pursuant to a contract or agreement, to provide the person or organization
Primary, Noncontributory shown in the Schedule with primary insurance such as is afforded by this policy, then in such case
Insurance - Scheduled this insurance is primary and we will not seek contribution from insurance available to such person
Person Or Organization or organization.
Schedule
Persons or organizations that you are obligated, pursuant to a contractor agreement, to provide with
such insurance as is afforded by this policy.
All other terms and conditions remain unchanged.
Authorired Representative Q� A'
Liability Iraurancs AddlYonal Ineurad - Scheduled Pe►sm Or Orgarizatlm
lest page
Form 80-02-2967(Rev. 5-07) Endorsement
Page 2
8 or 10 767
POIiCy #35929623WCE
CondMons
(continued)
Transfer Or Waiver Of We will waive the right of recovery we would otherwise have had against another person or
Rights Of Recovery organization. for loss to which this insurance applies, provided the inbvredhas waived their rights
Aonst Others of recovery against such person or organization in a contract or agreement that is executed before
such loss.
To the extent that the insured's rights to recover all or part of any payment made under this
insurance have not been waived, those rights are transferred to us. The marred must do nothing
after loss to impair them. At our request, the insisted will bring suit or transfer those rights to us
and help us enforce. them.
This condition does not apply to medieal expenses.
__ - -.__--
flab" rneurerroe
Form 80-02-2000(Rev. 4-01) contrad PQge 24 0132
9 of 10 767
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 04-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that
you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
State Person or Organization Job Description
California
This endorsement provides a blanket waiver of subrogation applicable to all jobs for persons or organizations
whom the Named Insured has agreed by written contract to furnish this waiver. The charge for this endorsement
shall be 5% of total manual premium, subject to a minimum premium of $250. This charge will be billed on your
next invoice based on current manual premium, and the final charge will be calculated and billed at the final
audit.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
Republic Indemnity Company of California
Company Number
27561
Insured
Economic and Planning Systems, Inc.
Policy Number
161508-17
Endorsement Number
6
Endorsement Effective
April 01, 2020
Printed On
March 09, 2020
Countersigned by :
WC000313
(Ed. 04-84)
0 1983 National Council on Compensation insurance.
Insured Copy
fooffo 767