Loading...
HomeMy WebLinkAboutPARSONS BRINCKERHOFF INC - INSURANCE CERTIFICATE (5)PARSBRI-01 HEVANS ACORO DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/23/2016 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: JLT Service Team JILT Specialty Insurance Services Inc. PHONE FAX 5847 Span Felipe St. A/c No. M: (713) 325-7615 (kC, No): (713) 789-0415 Suite 2800 ADDRESS: wsppbcertrequestaMltus.com Houston, TX 77057 INSURERS) AFFORDING COVERAGE NAIC N INSURER A: Zurich American Insurance Company 16535 INSURED INSURER a: LlbertV Insurance Corporation i42404 PARSONS BRINCKERHOFF, INC. 4139 Oregon Pike Ephrata, PA 17522 INSURER C : INSURER D : 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP OMITS LTR IN D WVD POLICY NUMBER MM/DD/YYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR X X GL09835819-03 04/01/2016 04/01/2017 AMA RENTED PREMISES Ea occurrence 300 000 $ , X MED EXP (Any one person) $ 6,000 Contractors Liab. PERSONAL & ADV INJURY $ 2,000,000 GEN'L GENERAL AGGREGATE $ 5,000,00 AGGREGATE LIMIT APPLIES PER: POLICY JECT a LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: I AUTOMOBILE LIABILITY COBINED SINGLE LIMIT Ea Maccident $ 2,000,000 BODILY INJURY (Per person) $ B X ANY AUTO X X IAS7-621-094060-035 10/01/2015 11/01/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB 1 OCCUR EACH OCCURRENCE $ EXCESS LIAB t.CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) ❑ N/A X WA7-62D-094060-015 10/01/2015 11/01/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE -EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 1 $ 2,000,000 E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) THIRTY (30) DAYS NOTICE OF 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. lyaC\IIal9G\I�1:lei 4$Ja: _ _091aMNW111010 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 ,_ 62-- © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD