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HomeMy WebLinkAbout453542 AECOM INC - INSURANCE CERTIFICATE (11)® DATE (MM/DDfYYYY) CERTIFICATE OF LIABILITY INSURANCE �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 CONTACT _NAME: Marsh Risk & Insurance Services PHONE FAX CA License 1t0437153 C. No. Eat)AC.No 777 South Figueroa Street ADDRESS: _ Los Angeles, CA 90017 Attn: LosAngeles.CertRequest@Marsh.Com INSURERS AFFORDING COVERAGE NAIC 8 06510 -STND-GAUE-17-18 12 04 2019 INSURER A: Zurich American Insurance Company 16535 INSURED AECOM INSURER B : N/A N/A URS Corporation INSURER C : Illinois Union Insurance Co 27960 600 Montgomery Street, 26th Floor INSURER D : SEE ACORD 101 San Francisco, CA 94111 .�.�e r=orlorAre k11"R1QC0• IhGnn915939 91 RFVISI()N NIIMRFR- vTHIS 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 MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO596589109 04/01/2017 04/01/2018 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occur ence $ 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 PRODUCTS -COMP/OP AGG $ 2,000,000 X POLICY ❑ PRO ❑ LOC JECT OTHER AUTOMOBILE LIABILITY EO MBIcNdeDtSINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? F­N] (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below NIA SEE ACORD 101 01/01/2019 X sTATUTE ERH E.L. EACH ACCIDENT $ 2,000,000 E.L DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 C ARCHITECTS & EN& EON G21654693 04/01/2017 04/01/2018 Per Claim/Agg $1,000,000 PROFESSIONAL LIAB. "CLAIMS MADE" Defense Included DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re. Right -of -Way Contractor's License. The City of Fort Collins is included as an Additional Insured against any liability arising out of the Ownership, Maintenance or use of that part of the area pertaining to the Right - of Way. Primary Insurance: It is agreed that such insurance afforded by this policy(ies) is Primary and Non -Contributory with the insurance maintained by the Additional Insured but only with respect to the work performed by the Named Insured. CERTIFICATE HOLDER _-f+ry�«r-�+ I w11 City of Fort Collins 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 ��-- V T`ltSt1-2UTb AI.UKU I.V Kt'v KA I Ivry. Au nynw rC3CI VCU. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 06510 LOC #: Los Angeles ACORL7® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh Risk & Insurance Services AECOM URS Corporation 600 Montgomery Street, 26th Floor POLICY NUMBER San Francisco, CA 94111 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 Stale of Pennsylvania - NAIC #19429 XWC 0910717 Nat'l Union Fire Ins Co - 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, MO, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, 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 AECOM and Its Subsidiaries GLO 5965891-09 Eft 04tol/2017 CVAIOLC1 POLICY NUMBER: GLO 5965B91-D9 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) locations Of Covered Operations Only those where required by written contract Information required to complete this Schedule, it not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The Insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behaff of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III- Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contractor agreement; or Page 2 of 2 CG 20 10 04 13 Q Insurance Services Office, Inc., 2012 Page 1 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13