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HomeMy WebLinkAboutInsurance Certificate: URS Energy & Construction Inc DATE /YYYY) AC° CERTIFICATE OF LIABILITY INSURANCE 03!27 /2015 /2015 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). PRODUCER CONTACT MARSH RISK & INSURANCE SERVICES NAME: 345 CALIFORNIA STREET, SUITE 1300 p% N o FAA/C No): CALIFORNIA LICENSE NO. 0437153 E-MAIL SAN FRANCISCO, CA 94104 ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 URSCOR-URS-C-15.16 C INSURER A : Zurich American Insurance Company 16535 INSURED INSURER B : Illinois Union Insurance Co 27960 & COnstwchOn, Inc. INSURER C : 10900 NE 8th Suite 500 INSURER D : Bellevue, OR 97077 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-002552867-01 REVISION NUMBER:0 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. NSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY GLO 5965891 07 04/01/2015 04/01/2016 EACH OCCURRENCE $ 2,000,000 COMMERCIAL GENERAL LIABILITY P 2,000,000 X PREMISES (Ea occurrence) $ CLAIMS-MADE M OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ A AUTOMOBILE LIABILITY BAP 596589307 04101/2015 04101/2016 COMBINED SINGLE LIMIT 2000000 Ea accident X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ ZED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- I ER AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ B ARCHITECTS & ENG. EON G21654693 10/0812014 04/01/2016 Per Claim/Agg 1,000,000 PROFESSIONAL LIAB. -CLAIMS MADE"" Defense Included DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Engineering Services for the Hosier Dam Stability Analysis The City of Ashland, Oregon, and its elected officials, officers and employees are included as Additional Insured as respects the General Liability and Automobile Liability policies, where required by written contract. Such insurance shall be primary insurance with respect to the interest of the additional insured's and any other insurance maintained by the additional insured shall be excess and not ;ontributing with the insurance required hereunder. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services David Denihan /l ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD o a m a U d m r 9 C= d G `f } m U J~ A m f3 ~ T G N £ 'D u' G R v m ~ a 6s v ~r ~ N r s~ % C, d £ ~ m m d, y, G N O s a^T NG, Q b m Q r a a f. A m `u a O O y ~ U 5 N ~3 m m 7 a~ £ G~ G y a o 9 `a m ~_j N W o pj a m o rn $ ~ u, v ~n A~ s r. m a fl aNO o m A Saf 6 m d~mm a 7a 51 d r3 G 0 9T 61 m q 0`~ C ~ `O Q d 9 N ~ m 9 @ 'a m_ 3 cmi ~ ~ O m ~ 9 >r d, q ~ ~ d d yami+ Q d4 O'er £ G E y L .n b. j P1 " O y a'j L Z m P O ill .t tj 7' O C v x. °N '6 m m d U L S `O b_ c 5 "l Yg m si mt yp ay« O m en mm ~ ~ gmoU~ o v U gne v ° ~ om ~ eyi si 4' dcttis c s=~ a J ~F.i +C C © 'd u ~ a a t~ ~o .am sq ~ m y t s7 id" 5~j Q L~ aJ xW N m ~ ~T Ra A ~ ~j ~ Hm` C v ~ d ~ ~ N 9 'q~ 6 i7" ~ N 7. N N~ 4 4S1G~ vcC~ m~¢U` vu ~`c~~a+ a L~a.a 7.~ i~ v Z z£ a' c i° ~d°d v} ems.8i m s m H a 4 6 3 0- t- e £ a~D mo o s aL Z. U y ~8 `~'~:n cam„£ m 7o m * m i % m m Or_,1 O T m 4 y 6~ a y m U W Z`~ Wm `Na 'Sig .0 c ~N N y N~ N O^y' yN Uy~ 4 } a a yam'm°~d U- o °Q-ac m ° r v fl.a xsom 'y~st°- s,. 7. mMCI $Ua ya it ~~G N D y' m R L0)TGaq~ O m_ G~9 L T3 m ~ ~ N i ~ N m~ N g fl Niti 000 =o°ac~ " 46 y -.1 " q r Uti p p y m `O d , G U G -M m N j uq~ 3 d Q' is m 9 dd `N 3 3 L u~L y ' cV'{'i esiaU cY, oa<-7 3mcm O ~ ~ ca+me£ cEm'°> Q`LC'z U1cs 3`' ~ L 6Ft j u ~ Gnat' U1 y Z y to cC. 4 ~ e R x AECOM and Its Subsidiaries SAP 5966893-07 Of 0 410 1 120 15 Blanket Notification to Others of Cancellation or Nan-Renewal Policy No. Eff. Date of Pol. Exp. Date of Pal. Eff. Date of End Producer No. Add'[ Prem Return Prem BAP 5965893-07 04101r?015 04101/2016 04101/2015 75320-000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form 1. The following is added to B. - General Conditions provision of Section IV - Business Conditions: A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured for any reason other than non-payment of premium, we will send, via electronic' means, a copy of the notification that such Coverage Part has been cancelled to each Personts) or Organization(s), shown in a Schedule (of Others) provided to us by the First Named Insured or its designated representative. Such Schedule: 1. Must be initially provided to us within 15 days: a. After the beginning ofthe policy period shown in the Declarations; or b. After this endorsement has been added to policy; 2. Must contain the names, addresses and e-mail' addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled; 3. Must be in an electronic format that is acceptable to us; and 4. Must be accurate. Such Schedule must be updated monthly and provided to us by the First Named Insured or its designated representative: during the policy period. Such updated Schedule must comply with Paragraphs 2, 3. and 4. above. B. Our sending of the electronic" notification described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation or non- renewal is sent to the first Named Insured. Delivery of the notification as described in Paragraph A. of this endorsement will be at least 30 days prior to the effective date of such cancellation or non-renewal as advised in our notice to the first Named Insured, or the longer number of days' notice if indicated in the Schedule, provided to us by the first Named Insured or its designated representative. C. Proof of sending the electronic" notification will be sufficient proof that we have complied with Paragraphs A. or B. of this endorsement. D. Our failure to send notification as described in Paragraphs A. or B. of this endorsement will not: 1. Extend the Coverage Part cancellation or non-renewal, 2 Negate the cancellation or non-renewal or 3. Provide any additional insurance that would not have been provided in the absence of this endorsement. E. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the Schedule provided to us as described in Paragraphs A. or B. of this endorsement. F. This endorsement is only applicable to Other Persons or Organizations that are listed on the Schedule. All other terms and conditions of this policy remain unchanged. U-CA-388 A CW (07194) Includes copyrighted material of Insurance Services Office, Inc., with its permission.