HomeMy WebLinkAbout102541 CH2M HILL ENGINEERS INC - INSURANCE CERTIFICATE (3)P52NMMV2
ACCM& CERTIFICATE OF LIABILITY INSURANCE
06 5/20 a"'
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 pollcy(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 lieu of such endorsement(s).
"PRODUCER LIC #0437153 1-212-948-1306
Marsh Risk a Insurance Services
CIRTS_8uyport0jacohe.com
633 W. Fifth Street
ME:
.PHONE FAX 1-212-9d8-1306
No:
EMAIL
ADDRESS:
INSURE 8 AFFORDING COVERAGE
NAIC0
INSURERA: ACE AMER INS CO
22667
Los Angeles, CA 90071
INSURED
cm HILL wo;n&E tB, INC.
INSURER a:
-
INSURER C :
INSURER D:
9191 South Jamaica Street
INSURER E:
INSURER F.:
Englewood, CO 80112-5946
COVERAGES CERTIFICATE NUMBER: 59592048 RFVIsinN NuMaFR-
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 DOCUMENTWITH 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.
LTRMR
TYPE OF INSURANCE
AWL
BUSH
POLICY NUYBER
POLICYEFF
POLICY EXP
LIYRB
A
Y
CONIN138 ULGENERALUABaJIY
HDO G71452694
07/01/20
07/01/21
EACH OCCURRENCE
S 7,000,000.
DAMAGE TO RM?rff—
P MI ES a - oe
$ 500,000
CLAIMS MADE OCCUR
Y
MED EXP Any one person)
j 5,000
CONTRACTUAL LIABIL177
PERSONAL dADV INJURY
S 7,000,000
AGGREGATE LIMIT APPLIES PER
POLICY PRO.
LOC
GENERAL AGGREGATE
$ 10,000,000.
GEML
X
-
PRODUCTS -COMPIOPAGG
j.10,000,600
$
OTHER:
A
AUTOMOBtLELUIBILrry
ISA 825307306
07/01/20
07/01/21
COMBINED SINGLE LIMIT
e accident .
$ .2,000,000
BODILY INJURY (Per peson)
S
-Y
ANY AUTO
-
-
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY e
O'er cdden0
$
HIRED NON�OWNEO
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
e 1 t
$
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
.CLAIMS -MADE
DE0 I I RETENTION
j
A
A
A
WORKERS
AND EYPLOYERB' LU181L1TY
ANDEMPLOYES'U COMPENSATION YIN
ANYPROPMETORIPARTNERIEXECUNVE N
OFFICERa1EMSEREXCLUDED7
WwWarory In NH)
NIA
NCO C67460340 IDS10 Only
SCP C67460388 (WI)
WLR C57460303 (ADS)
87/01/20
07/01/20
07/01/20
07/01/21
07/01/21
07/O1/21
Y STATUTE FOR
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
-"
0 yyeess,, describe odor
OESCRRON OF OPERATIONS belay
E.L. DISEASE -P000Y LIMIT
j 1,000,000
A
PROFESSION7AL LIABILITY
BON G21655065 011
07/01/20
07701/21
PM CLAIM/PBR AGO
2,000.000
.CLA-W NAM.
AGGREGATE
DEFENSE INCLUMM
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AAdlapul Rwna*s SdwWuI% may be eseohsd Bmori epaie is requtmd)
LOCATION: Englewood, CO. CONTRACT AMIMNISTRATOR: Oretcban Sage. Re: Contract# 84971 On -Call for RFP 9497 Stormwater
Consulting Engineering Services . The City its officers, agents and employees are included as an additional insured on
the General Liability and Automobile Liability Policies as required by written contract or agreement.. *$2,250,000 SIR
for states of: AE, LA, 0E, TY. *THE THEME, CONDITIONS, AND Ln.aTS PROVIDED IINDSR THIS CERTIPICATE OF ralSDRANCE WILL NOT
EXCEED OR BROADEN IN ANY WAY THE TERNS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT.*
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins, Colorado THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
ATTN:Purchasing Department
P.O. Box 580 AUTHORIZEOREPREBENTATIVE
Fort Collins, CO 80522
i II8A CJ
01988.2015 ACORD CORPORATION. All riehts reserved
ACORD 25 (Y016103) The ACORD name and logo are registered marks of ACORD
Cert Renewal
59592048
M
P32WUN2
DATE
SUPPLEMENT TO CERTIFICATE OF INSURANCE 06/25/2020
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