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HomeMy WebLinkAbout453542 AECOM INC - INSURANCE CERTIFICATE (9)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/07/2017 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 NAME: Marsh Risk & Insurance Services PHONE FAX CA License #0437153 (A/C t o.-Eat1z -- (A/C, 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 -STND-GAUE-17-18 04 2019 INSUREDAECOM INSURER B : N/A N/A INSURER C : Illinois Union Insurance Co 27960 URS Corporation INSURER D : SEE ACORD 101 600 Montgomery Street, 26th Floor San Francisco, CA 94111 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-002146994-21 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. INSR LTR OF INSURANCE ADDLSUBRTYPE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM I D/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO 5965891 09 04/01/2017 04/01/2018 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR AMA E T EN PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- JECT LOC POLICY PRODUCTS - COMP/OP AGG 0 $ 2,000,000 N $ OTHER: A AUTOMOBILE LIABILITY BAP 5965893 09 04/01/2017 04/01/2018 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per Person) _ $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIABH CLAIMS -MADE = I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? ❑N (Mandatory in NH) NIA SEE ACORD 101 01/01/2019 X PER oTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000.000 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/Agg 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: Project No.: 22236040 - Dry Creek Basin Flood Control Project GERTIFIGATE HOLDER City of Fort Collins 215 North Mason Street 2nd Floor PO Box 580 Fort Collins, CO 80522-0580 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 AGENCY CUSTOMER ID: 06510 LOC #: Los Angeles __1 6h Ia AGENCY Marsh Risk & Insurance Services POLICY NUMBER CARRIER ADDI I IUNAL KLMAKKb Jl.r1r_L)UL r_ NAIC CODE NAMED INSURED AECOM URS Corporation 600 Montgomery Street, 26th Floor San Francisco, CA 94111 EFFECTIVE DATE: HVVI I IVIYHL rtC111HrtnJ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation/Employer Liability cont 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, NC, 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. n r. r,wrl�u w!I _..9a4..­. A ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD