HomeMy WebLinkAbout102541 CH2M HILL ENGINEERS INC - INSURANCE CERTIFICATE (4)P52 VM*2
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ACOR& CERTIFICATE OF LIABILITY INSURANCE
o6 5/2D° o"
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, certain policies may require an endorsement A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement e .
PRODUCER LIC #0437133 1-212-948-1306
Marsh Risk a Insurance Services
CIRTS_BuDPortgjacobe.CC®WC
AT
NAME:
PHONE FAX 1-212-948-1306
No)'.Ea
TAIL
633 W. Fifth Street
ADDRESS: -
INSURE S AFFORDING COVERAGE
NAIC6
INSURERA: ACE AMEN INS CO
22667
LOB Angeles, CA 90071
INSURED
INSURER B :
CH2N HILL ENGINEERS, INC.
IN9URERC:
INSURERD:
9191 South Jamaica Street
INSURERS:
INSURER F:
Englewood, CO 60112-5946
CnVFRARFLC CFRTIFICATF MIIMRFR• 5Y5Y14a4 RFVICInR RIIMRFR-
_
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 REOUIREMENT,_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.
ILNSRm
TYPE OF INSURANCE
POUCYNUMBER
MMUCYEFF
POLICMMMD EXP
LIMITS
A
X
COMMERCALGENERALLIASUJIY
EDO 071452694
07/01/20
07/01/21
EACH OCCURRENCE
5 7.000,000
CLAIMS-MAOE ri� OCCUR
PREMITED Ee DAMAGETORFN rmnce
$ 500,000
%
MED EXP one n)
S 5,000
CONTRACTUAL LIABILITY
PERSONAL B ADV INJURY
$ 7,000,000
GENL AGGREGATE OMIT APPLIES PER
GENERAL AGGREGATE
S 10,000,000
% POLICY JPECT LOC
PRODUCTS -COMPIOP AGG.
i 10,000,000
t
OTHER
A
AUTOMOBRELABRITY
ISA 925307306
07/01/20
07/01/21
COMBINED aMBIINs NEDSINGLELIMIT
t 2,000,000
BODILY INJURY (Per Person)S
%
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Pe,eccMem)
-
$
PROPERTY DAMAGE
=Idwl
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
E
UMBRELLA LAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
I
EXCESS LAB
CLAIMS -MADE
DED I I RETENTION S
$
A
A
A
ANDEmRSCOMPuAaiLrN
AND EMPLOYERS' LABILITY YIN
ANYPROPRIETORIPARTNEFUEXECUTNE
OFFICERNEMBERE)(CWDED?
(Mandatory In NH)
NIA
WCU C67460340 (OHIO Only
SCF C67460388 (WI)
NLR C67460303 (ADS)
e7/01/20
07/01/20
07/01/20
07/01/21
07/01/21
07/01/21
% PEAT ERH
E.L. EACH ACCIDENT
-E 1,000,000
E.L. DISEASE -EA EMPLOYEE
5 1, 600, 000
8 ym, describe under
DESCRIPTION OF OPERATIONS belav
E.L. DISEASE -.POLICY LIMIT
1,000,000
$ -
A
PROFESSIONAL LIABILITY
RON G21655065 011
07/01/20
07/01/21
PER CLAMN/PER AGO
2,000,000
-CLAIMS BADE*
AGGREGATE
DEFENSE INCLUDED
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addidand Remerlo Schedule, may be cSached N mom space IF rpldmd)
LOCATION: Englewood, CO.. PROJECT NOR: Al Paquet. CONTRACT ADMINISTRATOR: Gretchen Sage. RE: ON -CALL FOR RFP 7575
CONSULTING ENGINEERING SERVICES WTP FACILITY DESIGN AMID CONSTRUCTION SMMICBB FOR CAPITAL IMPROVEMENTS. THE CITY ITS
OFFICERS, AGENTS AM EMPLOYEES IS INCLUDED AS AN ADDITIONAL INSURED ON THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY
POLICIES AS REQUIRED BY WRITTffii CONTRACT OR AGREEMENT. *82,000,000 SIR FOR STATE OF: ORIO. *THE TERNS,
CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE OF INSURANCE WILL NOT EECERD OR BROADEN IN ANY WAY THB TERMS,
CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT.*
CITY OF FORT COLLINS, COLORIM
ATTN: PURCHASING DEPARTMENT
P.O. BOX Soo
COLLINS, 00 80522
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 REPRESENTATIVE
1
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LU
ACORD 25 (2016103)
Cert_Renerval
59591484
The ACORD name and logo are registered marks of ACORD
P52W)2XW2
SUPPLEMENT TO CERTIFICATE OF INSURANCE I 0612.512020
CMX HILL MMMMW, 3:NC.
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