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HomeMy WebLinkAbout492167 TETRA TECH RMC INC - INSURANCE CERTIFICATE (2)ACC ® CERTIFICATE OF LIABILITY INSURANCE DATE(SM2 /DOD,rMY) 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 Aon Risk Insurance services West, Inc. Los An el es CA Office CONTACT NAME: (A/C. No. Ext): (866) 283-7122 FAX -0105 ( . No ): (800) 363 E-MAIL ADDRESS: 707 wi 1 shire Boulevard suite 2600 INSURER(S) AFFORDING COVERAGE NAIC # Los Angeles CA 90017-0460 USA INSURED INSURERA: National Union Fire Ins Co Of Pittsburgh 19445 Tetra Tech RMC Inc. INSURERB: AIG Europe Limited AA1120841 1576 Sherman St., Suite 100 Denver CO 80203 USA INSURER C: The Insurance Co of the State of PA 19429 INSURER D: American Home Assurance Co. 19380 INSURERE: Lexington Insurance Company 19437 INSURER F: COVERAGES CERTIFICATE NUMBER: 570068505370 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD SUER POLICY NUMBER MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL FDD/YYYY 1 1 1 1 1 EACH OCCURRENCE $2,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED$1,000,000 PREMISES Ea occurrence MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $4,000,000 POLICY PRO- JECT JECT LOC PRODUCTS - COMP/OPAGG $4,000,000 OTHER A AUTOMOBILE LIABILITY CA 428-80-55 10/01/201710/01/2018 COMBINED SINGLE LIMIT Ea accident $2,000,000 BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE HIREDAUTOS NON -OWNED Per accident ONLY AUTOS ONLY B X UMBRELLA LIAB OCCUR CSUSA1702199 10/01/2017 10/01/2018 EACH OCCURRENCE $5,000,000 EXCESS LIAB X CLAIMS -MADE AGGREGATE $5,000,000 DED I X RETENTION4100,000 C WORKERS COMPENSATION AND WC014629496 10/01/2017 10/01/20,18 X I PER I OTH- STATUTE ER D EMPLOYERS' LIABILITY YIN wc014629497 10/01/2017 10/01/2018 E.L. EACH ACCIDENT $1 , 000 , 000 C ANY PROPRIETOR / PARTNER, EXECUTIVE NIA wc014629498 10/01/2017 10/01/2018 C OFFICER/MEMBEREXCLUDED? (Mandatory in NH) wc014629499 10/01/2017 10/01/2018 E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 , 000 , 000 E Env contr Prof 028182375 10/01/2017 10/01/2019 Each Claim $5,000,000 SIR applies per policy ter s & condi ions Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as additional insured with respect to the General Liability policy where required by written contract. Insurance is Primary and Non -Contributory. A waiver of Subrogation is granted in favor of City of Fort Collins on the General Liability policy. See Attached endorsements. SStop Gap Coverage for the following states: OH, WA, WY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS - City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Opal Dick P.O. Ft. Box 580 Collins Co 80522 USA c'an (C✓ndfr�tancc �ott�ierd /��ra d 0 r m 0 co 0 LO ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD