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HomeMy WebLinkAboutInsurance Certificate: CH2M Hill Engineers Inc P5260028002 - a oN ® DATE(MMIDWYYYY) ARD CERTIFICATE OF LIABILITY INSURANCE 06/15/2023 L.---- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY.AND CONFERS NO RIGHTS UPON THE CERTIFICATE'HOLDER.THIS kJr CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,-EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES sr{ ` u, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED cn en 'REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. p IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poiicy(les)must have ADDITIONAL INSURED provisions or be endorsed: `n 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 LIC #0437153- 1-212-948-1306 - CONTACT - "cr Marsh Risk & Insurance Services PHONE - FAX . CIRTS_Support@jacobs.com INC.No.Ext): (A1C,No):i-212-948-1306 AE-MAIL 633 W. Fifth Street ADDRESS: - INSURER(S)AFFORDINGCOVERAGE NAICN . Los Angeles, CA 90071 • , . .. " INSURER A:.ACE AMER INS CO 22667 INSURED INSURER 8 CH2M HILL ENGINEERS, INC. INSURER C: . C/O Global Risk Management INSURERD: 555 South Flower Street, Suite 3200 INSURERE: Loa Angeles, CA 90071 . INSURER F: COVERAGES CERTIFICATE NUMBER:68986326 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 rypE OF INSURANCE ADDL SUER - - POLICY EFF •POLICY EXP LIMBS LTR MSD WVD' POLICYNUMBER (MMIDDIYYYYI (MMIDDIYYYY1 A X COMMERCIALGENERALLIABILITY, EDO 047339273 07/01/23 07/01/24 EACHOCCURRENCE $ 7,000,000 DAMAGE TO RENTED .CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 500,000 X CONTRACTUAL LIABILITY MED EXP(Any one person) , $ 5,000 ' PERSONAL'S,ADV INJURY $ 7,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: .- GENERAL AGGREGATE $ 10,000,000. X .POLICY JEC I I LOC - PRODUCTS-COMPIOPAGG $ 10,000,000 OTHER: - $ A AUTOMOBILELIABILITY ISA H10736262 07/01/23 07/01/24 COa MBEOINGLELIMIT $ 2,000,000 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) . $ UMBRELLALIAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE . AGGREGATE . $ - . DED RETENTION$ $ • A WORKER9COMPENSATION WLR 050711481 (AOS) 07/01/23 07/01/24 X STATUTE ER AND EMPLOYERS'LIABILITY - - A ANYPROPRIETORIPARTNER/EXECUTIVE Y7 NIA WCU C50711559 (OH)* 07/01/23 07/01/24 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED?. I N A (Mandatory In NH) SCF C5071164A (WI) 07/01/23 07/01/24 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,descrIbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A PROFESSIONAL LIABILITY . EON G21655065 014 . 07/01/23 07/01/24 PER CLAIM/PER AGG 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached R morespace Is required) • LOCATION: Englewood, CO. CONTRACT ADMINISTRATOR: Darin Williams. RE: Wastewater Treatment Plant Outfall Relocation Preliminary Design and Permitting (Phase 1) . The City of Ashland, Oregon,- and its elected officials, officers and employees are included as an additional insured on the General:Liability and'Automobile Liability policies as.required, by written contract or agreement. Coverage provided by the above General Liability and Auto'policies shall be primary and non-contributory and is limited to the liability resulting from the named insureds ownership and/or operations. *THE TERMS, CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE'OF INSURANCE WILL NOT EXCEED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT.* , CERTIFICATE HOLDER - CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland - THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Paula Brown ' ' 20 East Main Street AUTHORIZEDREPRESENTATNE • Ashland, OR 97520. • I USA . ' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Cert_Renewal " 68986326 " P5260028002 - - 0 SUPPLEMENT TO CERTIFICATE OF INSURANCE 06/1D/20 5/2023 NAME OF INSURED: CH2M HILL ENGINEERS, INC. as 0 Additional Description of Operations/Remarks from Page 1> Additional Information: *$2,000,000 SIR FOR STATE OF: OHIO SUPP(05/04) P5260028002 I Marsh Risk&Insurance Services • 633 W.Fifth Street • Los Angeles,CA 90071 L' ti' Electronic Service Requested L� EBrx BPo 0 MIXED AADC 975 11699 0.7648 MB 0.528 111u1�11�1IJ11Iiu111II11i�ui1I11I'1'I111i�11111iii11111i1'1I1'1" City of Ashland 186 .. -20 E MAIN ST ASHLAND, OR 97520-1814 • • • This document was brought to you by CertificatesNow. If you have questions regarding the content of this document, please contact - the Producer/Agent listed on the certificate of insurance or the Insured listed - on the notice of cancellation/reinstatement. If you have any questions regarding this Certificate of Insurance, please email - CIRTS_Support@jacobs.com.- - To find out how you can send and receive all of your certificates of insurance- either by email, high speed fax or standard mail, email customercare@confirmnet.com- or visit our website at www.confirmnet.com • - cc:_ Darin Williams (EMAIL) • • • • • • • • • The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. • Certificate Delivery by CertificatesNow-www.ConfirmNet.com-877.669.8600 ■ PCOVERPORM Marsh Risk&Insurance Services 633 W.Fifth Street Los Angeles,CA 90071 202306193310 Electronic Service.Requested w" 0 MIXED" AADC 975 11699 0.7648MB .0.528 dlll°I'I'III'IIIduuiIIIiuIIjIII'IIIiIluliI'IIiI1�����1u11II11 City of Ashland 186 51 FJINBURN WAY ASHLAND, OR 97520-2735