Loading...
HomeMy WebLinkAbout453542 AECOM INC - INSURANCE CERTIFICATE (10)ACOR" I - ATE CERTIFICATE OF LIABILITY INSURANCE FD12111121117Dnrvr) 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 777 South Figueroa Street Los Angeles, CA 90017 Attn: LosAngeles.CertRequest@Marsh.Com 06510 -PROJ-GAUE-17-18 DENVE CO 04 2019 CONTACT NAME: PHONE FAX c No. Exf); (A/C. No): E-MAILDR INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Company 16535 INSURED AECOM TECHNICAL SERVICES, INC. 71717TH STREET, SUITE 2600 INSURER B : NIA N/A INSURER C : NIA N/A INSURER D : SEE ACORD 101 DENVER, CO 80202 INSURER E : INSURER F : .T�"r I-irv.r■- II■I d.I r00Zff111Fr11rlCL•C4 �V A7 LVI 0 MO 11 r VA 1.1 r. 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 I LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X GLO 596589109 04/01/2017 04/01/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE T RENT PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY Fq jE O LOC OTHER A AUTOMOBILE LIABILITY X BAP 5965893 09 04/01/2017 04/01/2018 Ea acccideDjSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAR DED RETENTION $ WORKERS COMPENSATION _ X STATUTE EERH $ D SEE ACORD 101 01/01/2019 E.L. EACH ACCIDENT $ 2,000,000 AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FN] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA E L DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7392 CIVIL ENGINEERING, DESIGN, DRAFTING & SURVEY SERVICES ON -CALL AGREEMENT 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 01 BEHALF OF THE NAMED INSURED. CERTIFIGAI L HULUtK City of Fort Collins Attn: John Stephen - Senior Buyer P.O. Box 280 Fort Collins, CO 80524 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 V l Voo-Au 10 PA"Vr[V ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 06510 _ LOC #: Los Angeles 1q AC40 ADDITIONAL REMARKS SCHEDULE Page 2 of 2 L__ AGENCY Marsh Risk & Insurance Services NAMED INSURED AECOM TECHNICAL SERVICES, INC. 71717TH STREET, SUITE 2600 DENVER, CO 80202 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: 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 WC 014629525 American Home Assurance Company - NAIC #19380 WC 014629526 The Insurance Company of the State of Pennsylvania - NAIC #19429 WC 014629527 The Insurance Company of the State of Pennsylvania - NAIC #19429 WC 014629528 The Insurance Company of the State of Pennsylvania - NAIC #19429 WC 014629529 The Insurance Company of the State of Pennsylvania - NAIC #19429 XWC 0910717 Nafl Union Fire Ins Cc - NAIC #19445 qualified States Covered CA AK, AL, AR, AZ, CO, CT, DC, DE, GA, HI, IA, ID, IL, IN, KS KY, LA, MD, MI, MN, M0, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SO, TN, TX, UT, VA, VT, WV MA, WI (ND, OH, WA, WI, WY - Covered for Stop -Gap EL only) FL ME OH, Ohio Qualified Self Insured (QSI) - SIR: $500,000; Only applicable to specific 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. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD