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HomeMy WebLinkAboutInsurance Certificate: AECOM ' 7 ® ACOO DATE(MM/DD/YYYY)R CERTIFICATE OF LIABILITY INSURANCE 12/07/2017 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 Marsh Risk&Insurance Services PH PHON: ONE FAX CA License#0437153 (A/c.No.Exti: (A/c,No): 777 South Figueroa Street E-MAIL Los Angeles,CA 90017 ADDRESS: Attn:LosAngeles.CertRequest©Marsh.Com INSURER(S)AFFORDING COVERAGE NAIC# 06510-STND-GAUE-17-18 Seat° GLALP 12 2020 _INSURER A:Zurich American Insurance Company 16535 INSURED ECOM INSURER B:N/A N/A URS Corporation INSURER C:Illinois Union Insurance Co 27960 1501 4th Avenue,Suite 1400 INSURER D:SEE ACORD 101 Seattle,WA 98101 INSURER E: _INSURER F: COVERAGES CERTIFICATE NUMBER: LOS-002168162-22 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR 1NSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY GLO 5965891 09 04/01/2017 04/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ BAP 04/01/2017 04/01/2018 COMBINED SINGLE LIMIT $ 1000 000 A AUTOMOBILE LIABILITY (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ D WORKERS COMPENSATION SEE ACORD 101 01/01/2018 01/01/2019 X PER AND EMPLOYERS'EMPLOYERS'LIABILITY STATUTE ER Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? © N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C ARCHITECTS&ENG. EON G21654693 04/01/2017 04/01/2018 Per Claim/Agg 2,000,000 PROFESSIONAL LIAB. "CLAIMS MADE" Defense Included DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Re:Hosier Dam PMF Study Update;PO#604 The City of Ashland,Oregon is named as additional insured for GL&AL coverages,but only as respects work performed by or on behalf of the named insured and where required by written contract. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to the GL&AL coverages. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attention:Pieter Smeenk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 AUTHORIZED REPRESENTATIVE of Marsh Risk&Insurance Services James L.Vogel ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 06510 LOC#: Los Angeles ACRD ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh Risk&Insurance Services AECOM URS Corporation POLICY NUMBER 1501 4th Avenue,Suite 1400 Seattle,WA 98101 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS 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 States Covered WC 014629525 American Home Assurance Company-NAIC#19380 CA WC 014629526 The Insurance Company of the State of Pennsylvania-NAIC#19429 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 WC 014629527 The Insurance Company of the State of Pennsylvania-NAIC#19429 MA,WI(ND,OH,WA,WI,WY-Covered for Stop-Gap EL only) WC 014629528 The Insurance Company of the State of Pennsylvania-NAIC#19429 FL WC 014629529 The Insurance Company of the State of Pennsylvania-NAIC#19429 ME XWC 0910717 Nat'l Union Fire Ins Co-NAIC#19445 OH,Ohio Qualified Self Insured(05I)-SIR:$500,000;Only applicable to specific qualified 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