HomeMy WebLinkAbout466828 AECOM TECHNICAL SERVICES INC - INSURANCE CERTIFICATE (8)ACORU' CERTIFICATE OF LIABILITY INSURANCE
�� vv2017
DATE(MM/DD/YYYY)
12/7/2015
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(les) 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 Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #OF15767
Irvine 92612
UUNIAUT
NAME:
PHONE(A/C, No EX1 : ac No
E-MAIL
ADDRESS
INS ER AFFORDING COVERAGE
NAI
949-2524400
INSURER A: *** SEE ATTACHMENT ***
INSURED AECOM
1075642 AECOM Technical Services, Inc.
1601 Prospect Pk
Fort Collins CO 80525-9769
INSURER B
INSURER C :
INSURER
INSURER
INSURER
COVFROrFS AHI:I 1-01 CFRTIFICATF NIIMRFR- 1'id'J(lddd ocrnernu wleeOCG. VVVVvvv
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.
INSR
TR
TYPE OF INSURANCE
ADDL
INSD
SUBR
POLICY NUMBER
POLICY EFF
IMMIDD
MM ICY EXP
LIMBS
COMMERCIAL GENERAL LIABILITY
EACH
OCCURRENCE
XXXXX7 x
CLAIMS -MADE ❑OCCUR
NOT APPLICABLE
PREMISES
Ea RENTED
nce
XXXXX?CX
MED EXP (Any oneperson)
XXXXXXX
PERSONAL & ADV INJURY
$ XXXYXXX
GEML AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ XXXXXXX
POLICY0JE� ❑LOC
PRODUCTS - COMP/OP AGG$XXXXXXX
OTHER
AUTOMOBILE
LIABILITY
LIMIT
(Ea accident)
$ XXXXXXX
BODILY INJURY (Per person)
$
ANY
NOT APPLICABLE
pAUTO
AUTOS WINED SCHEDULED
BODILY INJURY (Per accident
$ XXXXXXX
HIREDAUTOS NON -OWNED
AUTOS
PROPERTY DAMAGE
Peraccident)
$ XXXXXXX
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$ XXXXX7IX
EXCESS LIAB
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXX} x
DED I I RETENTION $
$
'4
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
N
SEE ATTACHED ACORD 101
1/1/2016
1/l/2017
TH-
X STA1
TUTE FR
E.L. EACH ACCIDENT
$ 2 000 000
ANY
OFFICER/MEMBERMEXCLUDEED4 ECUTIVE
NIA
E.L. DISEASE- EA EMPLOYEE
2,000,000
In NH)
If ym, dtory
If yes, describe antler
E.L. DISEASE- POLICY LIMIT
2,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Notice of Cancellation applies per attached endorsement. Professional Services Agreement between The City of Fort Collins, Colorado and AECOM
Technical Services, Inc. P 8047 Environmental Services.
A.cr�nrwnrr=nvcucn %,AN6rLLAI IUN Jee Attacnments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
134204" AUTHORIZED REPRESENTATIVE
The City Of Fort Collins, Colorado
P.O. Box 580
Fort Collins CO 80522
ZA�
ACORD 25 (2014/01) 01 8-201 C D C RPORATION. All rights reserved
fhe ACORD name and logo are registered marks of ACORD
ncoRv� CERTIFICATE OF LIABILITY INSURANCE 1/1/2017
DATE(MMIDD/YYYY)
12/7/2015
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(fes) 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 Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #OF15767
Irvine 92612
949-2524400
CONTACT
ME:
FAX
A/c No Ext :INC,No):
E-MAIL
ADDRESS,
INSURERAFFORDING COVERAGE
INSURERA: *** SEE ATTACHMENT ***
INSURED AECOM
1075642 AECOM Technical Services, Inc.
71717th St., Ste. 2600
Denver CO 80202-0202
INSURER B :
INSURER C :
INSURER D
INSURER
INSURER F :
Cf1VFRAQFS AFCTFOI CERTIFICATE NIIMRFR• I0Q5Ri47 RFVISIr1N NIIMRFR• XXXXXXX
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.
INSR
LTR
TYPE OF INSURANCE
AIDDL
SUBR
POLICY NUMBER
POLICY EFF IDDIYYYY
IPIOLICY EXP
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE El
I
NOT APPLICABLE
I
EACH OCCURRENCE
XXXXXXX
PREMISES Ea oworcDence
XXXXXXX
MED EXP (Any oneperson)
XXXXXXX
PERSONAL 8 ADV INJURY
$ XXXXXXX
GENT AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
OTHER
GENERAL AGGREGATE
$ XXXXXXX
PRODUCTS - COMP/OP AGG
$ XXXXXXX
$
AUTOMOBILE
LIABILITY
ANY AUTO
AUTOS NED SCHEDULED
HIREDAUTOS NON -OWNED
NOT APPLICABLE
ECOMBINED SINGLE LIMIT
$XXXXXXX
BODILY INJURY (Per person)
$ }{j{}{j{XXX
BODILY INJURY (Per accident
$ XXXXXXX
(Pr acEcde DAMAGE
$ XXXXXXX
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
NOT APPLICABLE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
DED I I RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OANY
FFICER/MEMSERiPARTNDE04�CUT�
(Myyaeenssdatory In NH)
DESCRIIPPTIION OF OPERATIONS below
NIA
N
SEE ATTACHED ACORD 101
I/I/2016
I/I/2017
PER OTH-
X I STATUTE FR
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
2000000
E. L. DISEASE - POLICY LIMIT is
2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Notice of Cancellation applies per attached endorsement. Mason Project
t,elcllrlt.Ale nVlucrt t Ant=tLLAIIUN ,5ee Attacnments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
10958542 AUTHORIZED REPRESENTATIVE
City of Fort Collins
P.O. Box 580
Fort Collins CO 80522
ACORD 25 (2014101) 19!88-2014-ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
ACORN' CERTIFICATE OF LIABILITY INSURANCE
1114 . Iul/2017
DATE(MMIDDNYYY)
12/7/2015 .
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 Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #OF15767
Irvine 92612
949-252 4400
CONTACT
AX
A/c No, E:t : (FA/C.No):
E-MAIL
ADDRESS,
E DING COVERAGE
INSURERA: *** SEE ATTACHMENT ***
INSURED AECOM
1075642 AECOM Technical Services, Inc. (EDAW, Inc.)
240 E. Mountain Ave.
Fort Collins CO 80524-2821
INSURER B :
INSURER C :
INSURER D
INSURER E•
INSURER F :
Cr1VFRARFS AFCTF(11 CFRTIFICATF NIIMRFR• 7R41100 RFVISION Nl1MRFR- XXXXXXX
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
(MMIDDrYYYY1
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
XXXXXXX
CLAIMS -MADE ElOCCUR
NOT APPLICABLE
DAMAGE TO RENTED
PREMISES Ea occurrence
XXXX�o{i{
MED EXP (Any oneperson)
XXXXXXX
PERSONAL & ADV INJURY
$ XXXXXXX
GENL AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ XXXXXXX
POLICY PRD LOC
PRODUCTS - COMP/OP AGG
$ XXXXXXX
$
OTHER
AUTOMOBILE
LIABILITY
ANY AUTO
NOT APPLICABLE
COMBINED SINGLE LIMIT
Ea accident
$ XXXXXXX
BODILY INJURY (Per person)
$ =,VX
AUTOWNED AUTOSULED
BODILY INJURY (Per accident
$ XXXXXXX
PROPERTY DAMAGE
Per accident
$ X'X'X'X'}(}{}{
NON -OWNED
HIRED AUTOS AUTOS
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$ XXX}{XXX
EXCESS LIAR
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
DED I I RETENTION $
$
A
WORKERS COMPENSATION YIN
AND EMPLOYERS' LIABILITYFR
OMY
FFICERILIEMSEREXCTNEWE � ECUT
(MyandMory In NH)
If DESCRIPTION OF OPERATIONS below
NIA
1'
SEE ATTACHEDACORD101
1/1/2016
1/l/2017
X STATUTE OTH-
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
2,000,000
E.L. DISEASE -POLICY LIMIT
s2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached N more space is required)
Notice of Cancellation ap lies per attached endorsement. RE: PROJECT #04030071.01 / OLD TOWN SQUARE PLAZA RENOVATIONS P-957. A Waiver
of Subrogation is afford) to the certificate holder where required by written contract. See attached Waiver of Subrogation endorsement.
ctKITrlt AI t MULUtK 6PJ4"LLAI1V N See rutacnmems
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
2831300 AUTHORIZED REPRESENTATIVE
City Of Fort Collins
Attn: John Stephen, Cppo/Senior Buyer
P.O. Box 580
Fort Collins, CO 80522-058
ACORD 25 (2014/011 @191118-20140ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
ACC311IRU' CERTIFICATE OF LIABILITY INSURANCE
164.� I/l/2017
F DATE(MWDDIYI'YY)
1 12/7/2015
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 Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #OF15767
Irvine 92612
949-252-4400
CONTACT
NAM
hi
A/CNo Ext : A FAX No
E-MAIL
ADDRESS,
N RAFFORDING O RA E
NAIC
INSURER A: *** SEE ATTACHMENT ***
INSURED AECOM
1075642 AECOM Technical Services, Inc. (EDAW, Inc.)
240 E. Mountain Ave.
Fort Collins CO 80524-2821
INSURER B :
INSURER C :
INSURER :
INSURER
INSURER
rnvF:n Ar:FS AFCTPOl r7PQTIPICAT9=IUIIMRFR- ZA75dd1 RFVISInN NIIIIARFD• YSriCiCyyy
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
Wvp
POLICY NUMBER
POLICY EFF
MM
POLICY EXP
MM
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
XXXXXXX
CLAIMS -MADE ElOCCUR
NOT APPLICABLE
DAMAGE TO RENTED
PREMISES Ea occurrence
XXXXXXX
MED EXP (Any onePerson)
XXXXXX7C
PERSONAL B ADV INJURY
$ XXXXXXX
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYF_�JE� F_�LOC
GENERAL AGGREGATE
$ XXXXXXX
-
PRODUCTS - COMP/OP AGG
$ XXXXXXX
$
OTHER
I
AUTOMOBILE LIABILITY
ANY AUTO
NOT APPLICABLE
(Ea aOMBIc dEeDISINGLE LIMIT
$ XXXXXXX
BODILY INJURY (Per person)
$ XXXXXXX
AUTOS NED SCHEDULED
BODILY INJURY (Per accident
$ XX)CXX3CX
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
$ XXXXXXX
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$ XXXXXXX
EXCESS LIAB
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
DED I I RETENTION $
1
$
A
AND MPLo ERS'NIABILITY YIN
OMy
FFICEOPRIEBEREXCLUDE EXECUT1� H]
(Myandatory In NH)
dbounder
DE CRIPwaiTION OF OPERATIONS below
NIA`
N
SEE ATTACHED ACORD IOI
1/I/2016
1/I/2017
X I STATUTE o R
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
2000000
E.L. DISEASE -POLICY LIMIT Is
ZOOO OOO
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Notice of Cancegation applies per attached endorsement. Re: City of Fort Collins P1099 Urban, Environmental, and Land Use EDAW Project #08030029.01
(as -needed)
GCK I IrIUAIt HULUtK GANGCLLAIIUN See Attactiments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
3625"1 AUTHORIZED REPRESENTATIVE
City of Fort Collins
Attn: James B. O'Neill — Director of Purchasing/R
PO Box 580
Fort Collins CO 80522-0580
ACORD 25 (2014/01) @108-2014-ACORD C RPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
ACOR�a CERTIFICATE OF LIABILITY INSURANCE
`� I/1/2017
DATE(MMIDDIYYYY)
12/7/2015
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. R 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 Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #OF15767
Irvine 92612
949-2524400
CONTACT
NAME
FAX
A/ NoRt- Ext : AIc No):
E-MAIL
ADD
INSURE AFFORDING COVERAGE
NAIC III
INSURER A: *** SEE ATTACHMENT ***
INSURED AECOM
1075642 AECOM Technical Services, Inc.
71717th St., Ste. 2600
Denver CO 80202-0202
INSURER B :
INSURER C :
[INSURER
INSURER
INSURER F:
Cr1VFRAr:FS APCTT701 CFRTIFICATF NIIMRFR• 11 Q77r147 12FVIRIr1N NIIMRFR• XXXXXXX
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.
INSR
R
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE El OCCUR
NOT APPLICABLE
EACH OCCURRENCE
XXXXXXX
DAMAGE TO RENTED
PREMISE Ea occ .ce
XXXXXXX
MED EXP (Any oneperson)
XXXX}Q{X
PERSONAL & ADV INJURY
$ XXXXXXX
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYF—]JECT F—]LOC
OTHER
GENERAL AGGREGATE
$ XXXXXXX
PRODUCTS - COMPIOP AGG
$ XXXXXXX
$
AUTOMOBILE
LIABILITY
ANY AUTO
AUTOWNED SCHEDULED
HIRED AUTOS AOTOSWNED
NOT APPLICABLE
COMBINED SINGLE LIMIT
Ea accident
$ XXXXXXX
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$ XXXXXXj
PROPERTY
acatlen DAMAGE
$ XXXXXXX
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
NOT APPLICABLE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' COMPENSATION
y / N
MY
OFFICERIMEMSERIEXCLUERIE ECUTIVE
(Myyandatory In NH)
DESCRIPPTTIION OF OPERATIONS Eelow
NIA
N
SEE ATTACHED ACORD 101
1/l/2016
1/l/2017
X PER FR
E.L. EACH ACCIDE14T
s 2,000,000
E.L. DISEASE - EA EMPLOYEE
2 OOO 000
E.L. DISEASE - POLICYLIMIT
2 OOO OOO
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached B more space is required)
Notice of Cancellation applies per attached endorsement. RE: 7392 Civil Engineering, Design, Drafting & Survey Services On -call Agreement
ULK I IhiGA I t[ KULULK GANGtLLAIIUN Jee Attacnments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
11922057 AUTHORIZED REPRESENTATIVE
City of Fort Collins
Attn:John Stephen/Senior Buyer
PO Box 280
Fort Collins, CO 80524
ACORD 25 (2014/01) @111188-201141ACORD CORPORATION. All Hants reserved
The ACORD name and logo are registered marks of ACORD
ACORD' CERTIFICATE OF LIABILITY INSURANCE
llli� 1/1/2017
DATE(MMIDDIYYYY)
12/7/2015
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(les) 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 Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #OF15767
Irvine 92612
949-252- 400
CONTACT
NAME:
PHONEFAX
AIc No Ext :(A/C,No
E-MAIL
ADDRESS,
INSUREAFFORDING COVERAGE
NAI
INSURERA: *** SEE ATTACHMENT ***
INSURED AECOM
1075642 AECOM Technical Services, Inc.
71717th St., Ste. 2600
Denver CO 80202-0202
INSURER B :
INSURER C :
INSURER
INSURER
INSURER
COVERAGES AFCTF01 CFRTIFICATF NUMRFR- 13706919 REVISION Nt1MRFR- XXXXXXX
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.
INSR
R
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM D
POLICY EXP
MM D
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑ OCCUR
NOT APPLICABLE
EACH OCCURRENCE
XXXXX}IX
DAMAGPREMISEERE RENTED
XXXXXXX
MED EXP (Any one erson
XXXXXXX
PERSONAL B ADV INJURY
$ XXXXXXX
GEHL AGGREGATE LIMIT APPLIES PER:
POLICY❑ JECT El LOC
OTHER
GENERAL AGGREGATE
$ XXXXXXX
PRODUCTS - COMP/OP AGG
$ XXXXXXX
$
AUTOMOBILE
LIABILITY
ANY pAUTO
AUTOS NED gUTOSULED
HIRED AUTOS AUTO-0OWNED
NOT APPLICABLE
COMBINED accident) SINGLE LIMIT
$ XXXXXXX
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident
$ X){XXXXX
(Per PROPERTY DAMAGE
$ X}{XXXX}{
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
NOT APPLICABLE
EACH OCCURRENCE
$XXXXXXX
AGGREGATE
$ XXXXX}{j{
DED RETENTION $
$
A
WORKERS AND EMPLO ERs' LIABILITY YIN
OANY FFICER/MEM ER�EXCLUDED? ECUTIVE N
(Myto andary In NH)
DEC RIIPPTIION OF OPERATIONS below
N 1 A
N
SEE ATTACHED ACORD 101
1/1/2016
1/1/2017
TH-
X STATUTE oFIR
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
2,000,000
EL DISEASE -POLICY LIMIT
2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached U more space is required)
Notice of Cancellation applies per attached endorsement. Re: 8134 Vine & Lemay BNSF Improvements
GtK I IFIGAIt MULUtK GANGtLLAI IVN See AttacnmentS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
13706819 AUTHORIZED REPRESENTATIVE
The City of Fort Collins
Attn: Purchasing Dept.
PO Box 580
Fort Collins CO 80522
ACORD 25 (2014/01) @19188-20141ACORD CORPORATION. All rights reserved
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