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HomeMy WebLinkAbout214608 ATKINS NORTH AMERICA INC - INSURANCE CERTIFICATE (7)A16.� �® CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 0TI(MI 016 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 CONTACT NAME . Willis of New York, Inc. c/o 26 Century Blvd. P. 0. Box 305191 PHONE FAX 877-945-7378 888-467-2378 E-MAILq. certificates@willis.com Nashville, TN 37230-5191 INSURER(S)AFFORDINGOOVERAGE NAIC # INSURERA:Greenwich Insurance Company 22322-001 INSURED Atkins North America, Inc. INSURERB:QBE Insurance Corporation 39217-001 INSURERC:XL Specialty Insurance Company 37885-001 2001 NW 107th Avenue Miami, FL 33172-2507 INSURERD:>7nderwriter's at Lloyds 15792-001 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 24276772 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. INSR TYPE OF INSURANCE DDL SUB POLICY NUMBER POLICY EFF POLICY EXPITR LIMITS A X COMMERCIAL GENERAL LIABILITY y CGG740901605 4/1/2016 4/1/2017 Is 1,000,000 CLAIMS-MADEn OCCUR pDEAA6CCIHOOEECCCO�URRpRENCE PREMISES(taoccurence) $ 300,000 X MED EXP (Any one person) $ 10,000 Contractual Liability PERSONAL& ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PRO LOC JECT X PRODUCTS - COMP/OP AGG $ 2 0 0 0 0 0 0 I Is OTHER: A AUTOMOBILE LIABILITY y CAH740901705 4/1/2016 4/1/2017 COMBINEDSINGLE LIMIT (Ea accident) $ 2 000, 000 BODILY INJURY(Per person) $ X ANYAUTO X ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS X NON -OWNED AUTOS PROPERTYDAMAGE (peraccident) $ $ $ X UMBRELLALIAB X OCCUR CCU3977184 14/1/2016 4/1/2017 EACHOCCURRENCE $ 11000,000 AGGREGATE $ 11000,000 EXCESS LIAB CLAIMS -MADE DED ,RETENTION $ $ C WORKERS COMPENSATION CWG740901505 4/1/2016 4/1/2017 XOTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFRCER/MEMBER EXCLUDED? ((Mandatory in NH) ff describe under NSA E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 yes, DESCRIPTION OF OPERATIONS below D Professional B080111209P16 4/1/2016 4/1/2017 $1,000,000 Each Claim & Liability -Claims Made I$1,000,000 Annual Aggregate 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if more space is required) Re: 7307 Transportation Planning & Engineering Consultant On -Call - Purchase Order: 9117628 for Greenwich Insurance Company Best Rating: A XV QBE Insurance Corporation Best Rating: A XIV XL Specialty Insurance Company Best Rating: A XV Underwriter's at Lloyds AM Best Rating: A XV. Professional Liability policy written on claims -made basis. City of Fort Collins Attn: James O'Neill 215 N. Mason Street, 2nd Floor Fort Collins, CO 80522 UANUELLA 1 IUN 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 Coll:4875378 Tpl:2041793 Cert:24276772©1988-2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 33004588 LOC#: A� ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Atkins North America, Inc. Willis of New York, Inc. 2001 NW 107th Avenue Miami, FL 33172-2507 POLICY NUMBER See First Page CARRIER NAIC CODE EFFECTIVEDATE: See First Page See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE There are no Deductibles or Self -Insured Retentions on the General Liability, Automobile Liability, Workers Compensation and Umbrella coverages. Work Order 901003-01-11 City of Fort Collins is included as an Additional Insured as respects to General Liability and Automobile Liability. ACORD 101 (2008/01) Coll:4875378 Tpl:2041793 Cert:24276772©2008ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD