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102541 CH2M HILL INC - INSURANCE CERTIFICATE (2)
1*. O, O® CERTIFICATE OF LIABILITY INSURANCE D 2/15/20117D/YYYY) 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 Marsh Risk & Insurance Services CA License i10437153 777 South Figueroa Street Los Angeles, CA 90017 CONTACT NAME: PHONE r FAX (A/C.No), E-MAIL — ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 15114-12345-5EX2P-17-18J 029032 CA INSURED CH2M HILL ENGINEERS, INC. INSURER B INSURER C : 9193 SOUTH JAMAICA STREET ENGLEWOOD, CO 80112 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-003363697-14 REVISION Nt]MRFR- 2 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/YYWI POLICY EXP (MM/DDrYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X HDO G27865069 07/0112017 07/01/2018 EACH OCCURRENCE $ 7,000,000 DAMAGE TO R N PREMISES Ea occurrence $ 7,000,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 7,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER. POLICY ❑ PRO- ❑ JECT LOC GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 10,000,000 $ OTHER. A AUTOMOBILE LIABILITY X ISA H09055964 07/01/2017 07/01/2018 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DIED RETENTION $ $ A A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WLRC49115581 (AOS) SCFC49115623(WI) -WCUC49115611 (AK, LA, OH & TX) •SIR: $2,250,000 07/01/2017 07/0112017 07/01/2018 07/01/2018 07/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LIMIT $ 1,000,000 A PROFESSIONAL LIABILITY G21655065 008 07101/2017 07/01/2018 Each Claim & Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: ON -CALL FOR RFP 7575 CONSULTING ENGINEERING SERVICES WTP FACILITY DESIGN AND CONSTRUCTION SERVICES FOR CAPITAL IMPROVEMENTS. THE CITY ITS OFFICERS, AGENTS AND EMPLOYEES IS INCLUDED AS AN ADDITIONAL INSURED ON THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY POLICIES AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. `FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED THE LIMIT WILL BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. VCII I IrIVN 1 C MiLUCR %,AlYl.tLLA I IUN CITY OF FORT COLLINS, COLORADO ATTN: PURCHASING DEPARTMENT P.O. 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 of Marsh Risk & Insurance Services James Vogel ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD