HomeMy WebLinkAbout102541 CH2M HILL ENGINEERS INC - INSURANCE CERTIFICATE (2)P52W102M2
ACOR& CERTIFICATE OF LIABILITY INSURANCE
06 2 /20220"7
THIS CERTIFICATEIS 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 Ileu of such andorseme s .
PRODUCER LIC #04371S3 1-212=948-1306
Marsh Risk a Insurance Services
CIRTS-Aupport0jacobs.c001
633 N. Fifth Street
LOB Angeles, CA 90071
CNONTE•.
PHONE Ben.PAX No): 1-212-946-1306
E4MAIL - -
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC0
INSURERA: ACE A11ER INS CO
22667
INSURED
CH2M HILL ETa3II;lzER8, INC.
9191 South Jamaica Street
Englewood, CO 80112-5946
.INSURER B:
INSURER C
INSURER D:
INSURER E:
INSURERF• ----
-
CflVFRAr:GS
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE :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.
ILA
TYPE OF IN
POLICY NUtleER
POLICY EFF
fmumDrfyyln PoLN:I'.EXP
- LIMffB
A
X
COMMERCIALOENERALLIABILRY
HMO G71452694
07/01/20
07/Ol/21
EACH OCCURRENCE
f 1,000,000
CLAIMS -MADE a OCCUR
DAMAGE TO MENTED
PREMISSSIF,min
f 500,000
X
MEDF-XP (Any one anon
f 5,000
CONTRACTUAL, LIABILITY
PERSONAL 4ADV INJURY
f 1,000,000
GENL AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
f 1,000,000
PRODUCTS-COMP/OPAGG
f 1,000,000
g POLICY1:1 ECT LW
f
OTHER:
A
AUTOtlOORUUABILnY
ISA 325307306
07/01/10
07/01/21
COMBINED SINGLE LIMIT
woldenD
f -Me 000; 000
BODILY INJURY(Per pemmn)
f
g ANY AUTO
BODILY INJU0f1PwamMem)
f
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Mar sooldW)
f
f
UMBRELLAUAB
OCCUR
EACH OCCURRENCE
f
AGGREGATE
S
EXCESS LAB
CLAIMS -MADE
DED I I RETENTIONS
f
A
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LUDJLLRY
ANYPROPRIETORIPARTNERSXECUTNE a
OFFICERIMEMBEREXCLUDED7
(Mandatory In NH)
MIA
TPCO C67460340 (OHIO Daly
SCF C67460388 (NI)
WLR C67460303 (AOS)
a7/Ol/20
07/01/20
07/01/20
07/Ol/21
07/01/11
07/O1/21
X PER ERH.
EL EACH ACCIDENT
S 100,000
E.L. DISEASE - EA EMPLOYEE
f 100,000
E.L. DISEASE -POLICY LIMIT
f 500, 000
If ye0. describe under
DESCRIPTION OF OPERATIONS below
A
PROFESSIONAL LIABILITY
EON 021655065 011 -
07/01/20
07/01/21
PER CLAIM/PER AGG
1,000,000
-CLAIMS MApE.
AGGREGATE
DEFENSE IACLUM
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Addbbnal Remene SdWulk nay be aasohed N mm epees Is requbed)
PROJECT MGR: Brad Schutt. CONTRACT MGR: Gretchen Sage. RE: IntercounectiOn Modeling Project/Professional Services
Agreement. CONTRACT ffi® DATE: 6/11/2020. SECTOR:. Public. •$2,000,000 SIR FOR STATE OFt OHIO. City of Fort
Collins, its officers, agents and employees are added as an additional insured for general liability 6 auto liability
respects the negligence of the insured in the performance of insured-s services to cert holder under contract for
captioned work. •TSE TERMS, CONDITIONS, AND LIMITS PROVIDED MMER THIS CERTIFICATE OF INSUFMM WILL NOT EECMW OR
BROADEN IN ANr wAy Tea TERMS, COtIDITIONS, AND LIMITS AGREED TO WIDER THE APPLICABLE CONTRACT.*
of Fort Collins, Colorado
BOX sea
Collins, CO SOS22
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED
01988.2015 ACORD CORPORATION. All rights reserved.
7
as
ACORD 25 (2616103) The ACORD name and logo are registered marks of ACORD
Cert_Renemal
59587774