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Home My WebLink AboutInsurance Certificate: AECOM Technology Corporation --01 ACC>RO• CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 16.1 1 / 1 /2016 12/4/2014 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 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). CONTACT PRODUCER Lockton Insurance Brokers, LLC N AME: HONE License #OF15767 No, Ext : A JC, X No 4275 Executive Square, Suite 600 E-MAIL La Jolla CA 92037 ADDRE : (858) 587-3100 INSURER(S) AFFORDING COVERAGE NAIC q INSURER A : Insurance Company of the State of PA 19429 INSURED AECOM Technology Corporation INSURER B : 1389302 URS Energy & Construction, Inc. INSURER C : 10900 NE 8th St., Ste. 500 Bellevue WA 98004 INSURER D : INSURER E INSURER F COVERAGES AECTE01 CERTIFICATE NUMBER: 13242193 REVISION NUMBER: XXXXXXX 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE XXXXXXX CLAIMS-MADE ❑ OCCUR NOT APPLICABLE DAMAGE TO RENTED PREMISES Ea occurrence XXXXXXX MED EXP An one person) XXXXXXX PERSONAL & ADV INJURY $ XXXXXXX GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ XXXXXXX POLICY JECOT- LOC PRODUCTS - COMP/OP AGG $ XXXXXXX OTHER $ AUTOMOBILE LIABILITY Ee aBIN DtSINGLE LIMIT $ XXXXXXX ANY AUTO NOT APPLICABLE BODILY INJURY (Per person) $ XX]{};XXX SCH ALL OWNED A UTOSULED BODILY INJURY (Per accident $ XXXXXXX NON-OWNED PROPERTY DAMAGE $ XXXXXXX HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION $ $ A ANWORKERS COMPENSATION P D EMPLOYERS' LIABILITY Y/N N SEE ATTACHED ACORD 101 1/1/2015 1/1/2016 X STATUTE FIR ANY -1 N/A E.L. EACH ACCIDENT $ 10,000,000 OFFICER/MEMBOER EXCLUDED? ECUTIVE FN (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE 10,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Notice of Cancellation applies per attached endorsement. Evidence of Insurance CERTIFICATE HOLDER CANCELLATION See Attachments Yr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN i Q V ACCORDANCE WITH THE POLICY PROVISIONS. 13242193 AUTHORIZED REPRESENTATIVE City of Ashland 5 2015 Bill 20 East Main Street Ashland OR 97520 USA ACORD 25 (2014/01) @1U84014 ACORD tl5RP0kA-Tf0N. All rights reserved The ACORD name and logo are registered marks of ACORD insurer A: The Insurance Company of the State of Pennsylvania 'I'he Workers' Compensation coverage shown does not apply in monopolistic states. In the State of ND, OTT, WA, and WY Workers' Compensation coverage is provided by the State Fund. In those States, the above reference policies provide Stop-Gap Employers' Liability only. Workers' Compensation policies apply as indicated below: AFC0N1 Technology' Corporation WC 028328280 - CA \N C o28328281 - FL NN C 028328282 - N1A,ND,0H,NVA,NN'I,WY WC 028328283- ME WC 028328284 - AK,AZ,VA WC 028328285 - IL,KY,NC,NI I,U1',V1' WC 028328286 - NJ, PA VNC 028328287-AL,AR,CO,CT,DC,DE,GA,Hl,IA,ID,IN,KS,LA,NID,NII,MN,NIO,NIS,NTI',NF.,NNI,NV,NY,OK,OR,RI,SC,SD,"I'N;I'X,AC'V URS Corporation WC 028328288 - CA WC 028328289- FL \N 'C 028328290 - NIA,ND,01 I,AN"A,NN'I,AV'Y WC 028328291 - AL,AR,CO,Ci',DC,DE,GA,III,IA,ID,IN,KS,LA,NID,NII,NIN,NIO,NIS,NIT,NE,NNI,NV,NY,OK,OR,RI,SC,SD,TN,TX,AN-V NN'C 028328292-II,KY,NC,NH,U'F,VI' WC 028328293- NJ,PA \NVC 028328294 - AK,AZ,VA A C 028328295 - NIE ACORD 101 Miscellaneous Attachment : M503712 Master ID: 1389302, Certificate ID: 13242193 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 1/1/2015 forms a part of Policy No. Sh;ls ATTACHED ACORD 101 Issued to AI?COM Technology Corporation URS Lnergy & Construction, Inc. By The Insurance Company of the State of Pennsylvania LIMITED ADVICE OF CANCELLATION TO SCHEDULED ENTITIES (WORKERS' COMPENSATION ONLY) This policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an existing contractual obligation to notify a certificate holder(s) when this policy is canceled (hereinafter, the "Certificate Holder(s)") and the Named Insured has provided the Insurer, either directly or through its broker of record, either: (a) the name of the entity shown on the certificate, a contact name at such entity and the U.S. Postal Service mailing address of each such entity; or (b) the email address of a contact at each such entity; and 3. prior to the effective date of cancellation, the Named Insured confirms to the Insurer, either directly or through its broker of record, that the persons or organizations set forth in the Schedule below, as well as their respective addresses listed, should continue to be a part of the Schedule and, if not, the names of the persons or organizations that should be deleted, the Insurer will provide advice of cancellation (the "Advice'") to each such Certificate Holder(s) confirmed by the Named Insured in writing to be correctly a part of the Schedule within days after the Named Insured confirms the accuracy of the Schedule below with the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the Named Insured confirms the accuracy of the Schedule below with the Insurer. Proof of the Insurer emailing the Advice, using the information provided and subsequently confirmed by the Named Insured in writing, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following definitions apply to this endorsement: 1. Named Insured means the first named employer in Item 1 of the Information page of this policy. 2. Insurer means the insurance company shown in the header on the Information Page of this policy. WC 99 00 58 (Ed. 04/11) Attachment Code : D503695 Master ID: 1389302, Certificate ID: 13242193