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HomeMy WebLinkAboutPARSONS BRINCKERHOFF INC - INSURANCE CERTIFICATE (6)PARSBRI-01 JSPRINKLE ACORN DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/16/2015 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 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 NAMECT AT Service Team _ JILT Specialty Insurance Services Inc. PHONE 713 325-7615 FAX 5847 San Felipe St. A/C No Ell: ) A/c No : (713) 789-0415 Suite 2800 E-MAIL wsppbcertrequest@jltus.com Houston, TX 77057 INSURED PARSONS BRINCKERHOFF, INC. 4139 Oregon Pike Ephrata, PA 17522 INSURER A: Zurich American Insurance Company 16535 INSURER B: Liberty Mutual Insurance Company 23043 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. IEXP LTR TYPE OF INSURANCE INSD Syy D I POLICY NUMBER MMIDDIYYYY MM/D POLICYLICY EFF YY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADErX] OCCUR X X GL09835819-02 04/01/2015 04/01/2016 ED- PREMISES Eaoccunancs $ 300,000 MED EXP (Any one person) $ 5,000 X Contractual Liab PERSONAL & ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER: RALAGGREGATE GEN'L $ 5,000,000 PRO-- X LOC POLICY X JECT [PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accidntL $ 2,000,000 B X ANY AUTO X X AS7-621-094060-035 10/01/2015 11/01/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per acc dent UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB _ CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $ 2,000,00 B ANY PROPRIETOR/PARTNER/EXECUTIVE X A7-62D-094060-15 10/01/2015 11/01/2016 OFFICER/MEMBER EXCLUDED? ❑ (Mandatoryin NH) NIA E.L. DISEASE - EA EMPLOYE $ 2,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 2 000 000 $ r r DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIRTY (30) DAYS NOTICE CANCELLATION (PB #A); CITY FORT COLLINS MIST - CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSURED AS RESPECTS TO GENERAL AND AUTO LIABILITY, AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS RISK MANAGEMENT PO BOX 580 FORT COLLINS, CO 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD