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HomeMy WebLinkAbout378991 ICF INCORPORATED LLC - INSURANCE CERTIFICATEHolder Identifier : 7777777707070700077761616045571110767717016204447207442027772507300072640577046230130777451517127444707173110677231547075372330271773210763511023402661207360055130076130076727242035772000777777707000707007 7777777707070700073525677115456000722111407127112007122236342173110070333362520630000712333724216201107123336243063110070233372530620110702322625207311007022227353072001077756163351765540777777707000707007 Certificate No : 570062066259 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/11/2016 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. PRODUCER Aon Risk Services Northeast, Inc. New York NY Office 199 Water Street New York NY 10038-3551 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED INSURER A: Great Northern Insurance Co. 20303 INSURER B: Pacific Indemnity Co 20346 INSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.): (800) 363-0105 CONTACT NAME: ICF Incorporated LLC 9300 Lee Highway Fairfax, VA 22031 USA COVERAGES CERTIFICATE NUMBER: 570062066259 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 POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) insurance applies separately to each insured against whom claim is made or "suit" is brought. 4 - Waiver of subrogation is included to the extent permitted by law. FORM NUMBER: FORM TITLE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ADDITIONAL REMARKS EFFECTIVE DATE: CARRIER NAIC CODE POLICY NUMBER Aon Risk Services Northeast, Inc. AGENCY NAMED INSURED LOC #: AGENCY CUSTOMER ID: 570000024256 © 2008 ACORD CORPORATION. All rights reserved. See Certificate Number: See Certificate Number: The ACORD name and logo are registered marks of ACORD 570062066259 570062066259 ACORD 25 Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles: ACORD 101 (2008/01) ADDITIONAL REMARKS SCHEDULE Page _ of _ ICF Incorporated LLC SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $1,000,000 $1,000,000 $10,000 $1,000,000 $2,000,000 $2,000,000 A 06/25/2015 07/01/2016 Package - Domestic 3581-24-09 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X X X BODILY INJURY (Per accident) A $1,000,000 06/25/2015 07/01/2016 Automobile - All States COMBINED SINGLE LIMIT (Ea accident) 7352-29-55 EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH - B 06/25/2015 06/25/2016 PER STATUTE Workers Comp $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 7175-43-37 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Ft. Collins Utilities - ICF SW License Agreement 133652 1 - The City of Fort Collins, Fort Collins Utilities, its elected and appointed officials, employees and volunteers are included as Additional Insureds as respects General and Automobile Liability. 2 - The indicated coverage is primary and non-contributory but only as respects work being done by ICF Incorporated, LLC for the City of Fort Collins & Fort Collins Utilities. 3 - Except with respect to the limits of Insurance, and any rights or duties specifically assigned to the First Named Insured, CERTIFICATECANCELLATION HOLDER CityREPRESENTATIVE of Fort Collins AUTHORIZED Fort Collins Utilities 215 N. Mason St. 2nd Floor Fort Collins CO 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.