HomeMy WebLinkAbout215608 ATKINS NORTH AMERICA INC - INSURANCE CERTIFICATEDATE(MM/DDIYYYY)
��. CERTIFICATE OF LIABILITY INSURANCE 11/03/2017
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 CONTACT
MARSH USA, INC. NAME`
PHONE FAX
TWO ALLIANCE CENTER IAJC, No. _ __ A/C No):
3560 LENOX ROAD, SUITE 2400 E-MAIL
ATLANTA,GA 30326 ADDRESS:
INSURERS AFFORDING COVERAGE NAIC #
000000-Atkin-GAWUp-17-18 INSURER A: Zurich American Insurance Company 16535
INSURED INSURER B : American Guarantee & LiabilRy Ins Co 26247
Atkins North America, Inc.
4030 West Boy Scout Blvd. Ste. 700 INSURER c :
Tampa, FL 33607-5713 INSURER D :
INSURER E :
^^MAnmo WINIAQCO• ATI_nnd77AQaR_n9 RFVIRIr)N NIIMRFR• 0
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
SUBR
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
GLO137576-03
10/15/2017
10/15/2018
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE lxl OCCUR
PREMISES Ea oNcur ence
$ 1,000,000
MED EXP (Any one person)
$ 50,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS - COMP/OP AGG
$ 4,OOQ000
X POLICY ❑JECT PRO ❑ LOC
$
OTHER.
A
AUTOMOBILE LIABILITY
BAP 0137575-03
10/15/2017
10/15/2018
COMBINED SINGLE LIMIT
Ea accident
$ 2,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED E NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
X
UMBRELLA LIAB
X
OCCUR
AUC 9304200-15
10/15/2017
10/15/2018
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
EXCESS LIAB_
CLAIMS -MADE
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? �
(Mandatory in NH)
NIA
WC0137577-03
10/15/2018
X STATUTE OERH
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: 7307 Transportation Planning & Engineering Consultant On -Call - Purchase Order 9117628 for. Work Order 901003-01-11
City of Fort Collinsis included as additional insured with respect to General Liability and Auto Liability where required by written contract.
GtK I IFIGA 1 t HULUtK I.AIVI+CLLH I IVI9
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
AW James O'Neill THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
215 N. Mason Street, 2nd Floor ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee �'t au�o►�+ tnsr es
U 19St3-ZU1b AGUKU GUKF'UKA 1IUN. All ngnLS reserveo.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD