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HomeMy WebLinkAbout453542 AECOM INC - INSURANCE CERTIFICATE (8)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1210712017 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 #0437153 CONTACT NAME: PHONE AC No : E-MAIL ADDRESS: 777 South Figueroa Street Los Angeles, CA 90017 Attn: LosAngeles.certrequest@marsh.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Zurich American Insurance Company 16535 06510- LOC-GAUE-1 7-18 05 2019 INSURED ECOM INSURER B : NIA N/A INSURER C : Illinois Union Insurance Co 27960 6200 S. Quebec Street INSURER D : SEE ACORD 101 Greenwood Village, CO 80111 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-002123597-06 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. INSRPOLICY LTR TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER EFF MM/DD YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X GLO 5965891 09 04/0112017 04/01/2018 EACH OCCURRENCE $ 2,000,000 J CLAIMS -MADE lxl OCCUR DAMAGE To RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT [� LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY X BAP 5965893 09 04/01/2017 04101/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE --T- IDED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N] (Mandatory in NH) N/A SEE ACORD 101 01/01/2019 X STATUTE ORH E.L. EACH ACCIDENT $ 2'000f000 E.L DISEASE -EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 C ARCHITECTS & ENG. EON G21654693 04/01/2017 04/01/2018 Per Claim/ Aggregate $1,000,000 PROFESSIONAL LIAB. """CLAIMS MADE"""' DEFENSE INCLUDED DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: 8475 Civil On -Call - City of Fort Collins The City of Fort Collins, its officers, agents, and employees are named as additional insured for GL & AL coverages, but only as respects work performed by or on behalf of the named insured and where required by written contract. CERTIFICATE HOLDER The City of Fort Collins Purchasing Department 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 of Marsh Risk & Insurance Services James L. Vogel ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACOR" AGENCY Marsh Risk & Insurance Services POLICY NUMBER CARRIER AGENCY CUSTOMER ID: 06510 _ LOC #: Los Angeles ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED AECOM 6200 S. Quebec Street Greenwood Village, CO 80111 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation/Employer Liability cons. Policy Number Insurer States Covered WC 014629525 American Home Assurance Company - NAIC #19380 CA WC 014629526 The Insurance Company of the State of Pennsylvania - NAIC #19429 AK, AL, AR, AZ, CO, CT, DC, DE, GA, HI, IA, ID, IL, IN, KS KY, LA, MD, MI, MN, MO, MS, MT, INC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WV WC 014629527 The Insurance Company of the State of Pennsylvania - NAIC #19429 MA, WI (ND, OH, WA, WI, WY - Covered for Stop -Gap EL only) WC 014629528 The Insurance Company of the State of Pennsylvania - NAIC #19429 FL WC 014629529 The Insurance Company of the State of Pennsylvania - NAIC #19429 ME XWC 0910717 Nat'l Union Fire Ins Co - NAIC #19445 OH, Ohio Qualified Self Insured (QSI) - SIR: $500,000; Only applicable to specific qualified entities self -insured in the state of Ohio Waiver of Subrogation is applicable where required by written contract with respect to WC. If the insurer for the Workers Compensation policy cancels its policy for any reason other than for non-payment of premium, the insurer will provide 30 days notice of cancellation to those Certificate Holders that require it by written contract. Page 2 of 2 ACORD 101 (2008/01) v LVVO P%�Iw t, The ACORD name and logo are registered marks of ACORD