HomeMy WebLinkAbout102541 CH2M HILL ENGINEERS INC - INSURANCE CERTIFICATEPSjWM1jtlIM1$
ACOR& CERTIFICATE OF LIABILITY INSURANCEDATE
06/2 /202YYY)
6/2saoao
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: It 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.11eu of such.endorsement(s).
PRODUCER LIC A0437153 1-212-948-1306
Marsh Risk a insurance Services
CIRT9_SupportGjacobs.c=
633 W. Fifth StreetADDRESS:
CONTACT
-
PHONE FAX.
Noel-212-948-1306
MAIL
INSURERS AFFORDING COVERAGE
RAIC0
INSURER A: ACE AMER INS CO
22667
Los Angeles, CA 90071
INSURED
CMM HILT, ENGINEERS, INC.
INSURER B :
INSURER C :.
INSURER O:
9191 South Jamaica Street
.INSURER E :
INSURER F:
-Englewood, CO 60112-5946
CrTVGDarOP9 rDDT19ICATG u11aaDGD• 595133151 DNIQV1u ulluncD.
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.
INSR im
_ TYPE OF a1S11RANCE
POLICY NUMBER
POLICY EFF
POLICY EIP
LIMITS
A
X
COMMERCUILOENERALLIABILRY
BDO 071452694
07/01/20
07/01/21
EACH OCCURRENCE
5.1,000,000
CLAIMS -MADE OCCUR
EMISES E c u nce
$ 500,0 00
X
MEDEXP (Any one arson
$ 5.000
CONTRACTUAL LIABILITY
PERSONAL B ADV INJURY
t 1,000,000
GENT AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
S 11000,000
8: POLICY ❑ JECT 0LOC
PRODUCTS-COMP/OP AGG
$ 1,000,000
$
OTHER:
A
A_UTOMOBILELIABnrtY
ISA H25307306
07/01/20
07/01/21
COMBINED SINGLE U I
Me acddeM
S 1,000,000
BODILY INJURY(Per penon)
$ _
X
ANYAUTO— -- - --
_
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY(Pereccidem)
- -
6
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTYDAMAGE
Pw amide M
$
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
S
AGGREGATE
i
LFXOE89
CLAIMS -MADE
DED. RETENTION
$
A
A
A
WORKERS COMPENSATNIN. -
AND EMPLOYER$' LIABILITY YIN
ANYPROPRIETOPJPARTNERIERECUTNE
OFICERIMEMaEREXCLUDED7
(MaMaDory In NH)
NIA
-
WCU C67460340 JOHIO Only
BW C67460388 (WI)
WLR C67460303 (ADS)
e7/01/20
07/01/20
07/61/20
07/01/21
67/01/21
07/O1/21
g PER 07 -
A TE ER
E.L. EACH ACCIDENT
S 100,000
EL DISEASE - EA EMPLOYEE
$ 100,000
_ --
If' desalbe ulldm
DESCRIPTION OF OPERATIONS below- .
E.L. DISEASE - POUCY LIMIT
$ 500,060
A
PROFESSIONAL LIABILITY -
R N G21655065 011
07/01/20
07/01/21
PER CLAIM/PRR AGG
1,000,000
eCLAINE NAUB*
AGGREGATE
DEFENSE INCLUDED
DESCRIPTION OF UPS RATIONS I LOCATIONS I VEHICLE8 (ACORD 10/,_AddlBonal Ramama 6ahadule, may be aeached N mm apace Is nqubed)
PROJECT NO: Al Paquet. CONTRACT NOR: Gretchen Sage. REt 8737 Environmental Services for Salligan Water Supply
Project. CONTRACT ENO DATE: 6/25/2021. SECTOR: Public. *1112,000,000 SIR FOR STATE OF: OHIO. City of Fort
Collins, Colorado, its officers, agents and employees are added as an additional insured for general liability & auto
liability as respects the negligence of the insured in the performance of insured•a Services to cert holder under
Contract for captioned work. *THE TERMS, CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE OF INSURANCE WILL NOT
E%CBED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT. -
of Fort Collins, Colorado
P.O. Box 580
Collins, CO 80522
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION GATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
01988-2015 ACORD CORPORATION. All rlahts reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
Cert_Renewal
59583151