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Insurance Certificate: AECOM URS Corp. (2)
DATE(MM/DD/YYYY) ACO CERTIFICATE OF LIABILITY INSURANCE ATE(MM! 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(les)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 James Vogel . Marsh Risk&Insurance Services CA License#0437153 (PH/ONE.Est); 213-346-5098 FAX No): 212-948-0533 633W.Fifth Street,Suite 1200 E-MAIL James.l.v el marsh.com Los Angeles,CA 90071 ADDRESS: °g Attn:LosAngeles.CertRequest@Marsh.Com INSURER(S)AFFORDING COVERAGE NAIC# CN101348564-STND-GAUE-21-22 Seatti GLALP 12 2020 . INSURER A:ACE American Insurance Company 22667 INSUREDAECOM INSURER B:N/A N/A URS Corporation INSURER C:Illinois Union Insurance Co 27960 15014th Avenue,Suite 1400 INSURER D SEE ACORD 101 Seattle,WA 98101 INSURER E: , INSURER F: COVERAGES CERTIFICATE NUMBER: LOS-002168162-31 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 EXPIYLIMITS LTR INSD•WVD POLICY NUMBER (MM/DDYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY HDO G72486304 04/01/2021 04/01/2022 EACH OCCURRENCE $ 1,000,000 GE TO RENTED CLAIMS-MADE X OCCUR PRREM SES Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 5,000. PERSONAL&-ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X_ POLICY mai n LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JEC OTHER: $ A AUTOMOBILELIABILITY ISA H25549211' 04/01/2021 04/01/2022 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ X ANY AUTO • BODILY INJURY(Per person) $ OWNED SCHEDULEDBODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS — HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) _ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ D WORKERS COMPENSATION SEE ACORD 101 04/01/2021 04/01/2022 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE —i NIA E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBEREXCLUDED? 2,000,000 . (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 2;000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C ARCHITECTS&ENG. EON G21654693 005 04/01/2021 04/01/2022 Per Claim/Agg 2,000,000 ' PROFESSIONAL UAB. "CLAIMS MADE" Defense Included. DESCRIPTION OF OPERATIONS I LOCATIONS I 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 20—e.,..------- I ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 0002236 SP 0129 -C01-P02237-I City of Ashland Attention: Pieter Smeenk 20 East Main Street Ashland, OR 97520 ly F . 0129-01-00-0002236-0001-0005107 AGENCY CUSTOMER ID: CN101348564 • LOC#: Los Angeles A 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 WLR-C67806025 Indemnity Insurance,Company of North America-NAIC#43575 AOS WLR C67805987 ACE American Insurance Company-NAIC#22667 CA,MA SCE.C67806104 ACE American Insurance Company-NAIC#22667 WI Retro • 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 I The ACORD name and logo are registered marks of ACORD • r.*__. 0129-01-00.0002236-0002-0005108 Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline deliveryand in an effort to support our firm's commitment to sustainability,going forward,we would like to distribute your Certificates of Insurance electronically if possible. We are kindly requesting Certificate Holders provide us an email address where we can deliver your COI in the.future. Please send your response to: USOperations.email@marsh.com and provide the following information so that we can expedite your COI delivery: • Certificate#(Shown below Insured Name—e.g,:ABC:123456789-01) • E-Mail for future delivery: For undeliverable email addresses,our system is configured to automatically redirect the Certificate for deliveryvia USPS. Lastly, if you no longer need this COI please respond to USOoerations.emaiIt marsh.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery. Thank you. US Operations,Marsh USA, Inc.