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492167 TETRA TECH CONSTRUCTION SERVICES INC - INSURANCE CERTIFICATE (9)
A�RD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/26/2016 I 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 Aon Risk Insurance services West, Inc. Los Angeles CA Office CONTACT NAME: (A/CC..NNo. Ext): (866) 283-7122 FAX No ): (800) 363-0105 E-MAIL ADDRESS: 707 Wilshire Boulevard Suite 2600 INSURER(S) AFFORDING COVERAGE NAIC # Los Angeles CA 90017-0460 USA INSURED INSURER A: National Union Fire Ins CO Of Pittsburgh 19445 Tetra Tech Construction, Inc. INSURER B: The Insurance CO Of the State of PA 19429 2817 S 46th St. Phoenix AZ 85040 USA INSURER C: AIG Europe Limited AA1120841 INSURER D: Lexington Insurance Company 19437 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570059584854 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 Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 1 1 EACH OCCURRENCE $2 , 000 , 000 CLAIMS -MADE X I OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $1, 000 , 000 X MED EXP (Any one person) $10 , 000 X,C,U Coverage X Contractual Liability PERSONAL & ADV INJURY $2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4 , 000 , 000 POLICY � PRO � LOD JECT PRODUCTS - COMP/OP AGG $4 , 000 , 000 OTHER: A AUTOMOBILE LIABILITY CA 3194397 10/01/201S 10/01/2016 COMBINED SINGLE LIMIT Ea accident $2 , 000, 000 INJURY ( Per person) AUTOBODILY BODILY INJURY (Per accident) ALL OWNED SCHEDULED JANY AUTOS AUTOS NON -OWNED PROPERTY DAMAGE HIRED AUTOS X AUTOS (Per accident) C X UMBRELLA LIAB X OCCUR TH1500079 10/01/2015 10/01/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000 DED I X RETENTION $100, 000 B WORKERS COMPENSATION AND wC014267906 10/01/2015 10/01/2016 X SPERTATUTE EORH B EMPLOYERS' LIABILITY YIN WC014267908 10/01/2015 10/01/2016 E.L. EACH ACCIDENT $1, OOO , OOO B ANY PROPRIETOR / PARTNER / EXECUTIVE � NIA WC014267907 10/01/2015 10/01/2016 B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) wc014267912 10/01/2015 10/01/2016 E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 If yes, ESCRIPTIONOFO DESCRIPTION under OPERATIONS below workers Compensation - MA p E.L. DISEASE -POLICY LIMIT $1,000,000 D Contractor Prof 028182375 10/01/2015 10/01/2017 Each Claim $S,000,000 Prof/Poll Liab Aggregate $5,000,000 SIR applies per policy terins & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, Engineer, Engineer's Consultants and their respective officers, employees and Burlington Northern Santa Fe Railroad (BNSF) are included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract, with respect to the General Liability policy. Contractual Liability is included under the General Liability policy where required by written contract. A waiver of Subrogation is granted in favor of Additional insured as required by written contract but limited to the operations of the insured under said contract, with respect to the General Liability property. Stop Gap Coverage for the following states: OH, WA, WY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins AUTHORIZED REPRESENTATIVE 215 Mason St. 2nd Floor Fort Collins, Co 80522 USA e�4'an ��e'.�ifcJnaritancc e/ctz�ird � cJna ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD