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HomeMy WebLinkAbout378891 ICF INCORPORATED LLC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCED6/28/20,7 ATE(MM/DD/YYYY) r 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 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). PRODUCER AOn Risk Services Northeast, Inc. New York NY Office CONTACT NAME: (AJC. No. Ext): (866) 283-7122 ac No (800) 363-0105 E-MAIL ADDRESS: 199 Water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Great Northern Insurance Co. 20303 ICF Incorporated LLC INSURER B: Federal Insurance Company 20281 Attn: Misha Freimann INSURER C: 9300 Lee Highway INSURER D: Fairfax, VA 22031 USA INSURER E: INSURER F. COVERAGES CERTIFICATE NUMBER: 570067288596 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 INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY L" MM/DDIYYYY POLICY "I' MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 3S8124n9 0110112011 0710112018EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR Package - Domestic DAMAGEORENTED$1,000,000 PREMISES Ea occurrence X MED EXP (Any one person) $10 , 000 Prod/Comp Ops Inc[. PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 , 000 , 000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY 73522955 Automobile - All States 07/01/2017 07/01/2018 COMBINED SINGLE LIMIT Es accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED AUTOS X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LAB HOCCUR CLAIMS -MADE DED I RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 71754337 workers Compensation 07/01/2017 07/01/2018 X PEATUTE ERH E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE -EA EMPLOYEE $1,000,000 It.,=s describe Under DESCRIPTION OF OPERATIONS below _ E.L. DISEASE -POLICY LIMIT _._ $1, OOO, OOO DESCRIPTION OF OPERATIONS / LOCATIONS I 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, m CERTIFICATE HOLDER CANCELLATION M 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 Fort Collins Utilities 215 N. Mason St. 2nd Floor Fort Collins c0 80522 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000024256 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon Risk services Northeast, Inc. ICF Incorporated LLC POLICY NUMBER See Certificate Number: 570067288596 CARRIER NAIC CODE See Certificate Number: 570067288596 EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Description of Operations / Locations/ Vehicles. 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. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD