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HomeMy WebLinkAboutInsurance Certificate: AECOM URS Corp. (3) A DATE(MM/DD/YYYY) ® CERTIFICATE OF LIABILITY INSURANCE 03/31/2021 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. James Vogel Marsh Risk&Insurance Services CA License#0437153 {A/c No.Ext): 213-346-5098 FAX No): 212-948-0533 633 W.Fifth Street,Suite 1200 E-MAIL SS: James.l.vogel@marsh.com ADDRE Los Angeles,CA 90071 • Attn:LosAngeles.CertRequest@Marsh.Com INSURER(S)AFFORDING COVERAGE NAIC# CN101348564-STND-GAUE-21-22 Seattl GLALP 12 2020 INSURER A:ACE American Insurance Company 22667 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-002162305-29 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 SUER POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL UABIUTY HDO G72486304 04/01/2021 04/01/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES ERENTED occu ence) $ 1,000,000. MED EXP(Any one person) _ $ 5,000 PERSONAL&ADV INJURY_ $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PROT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JEC OTHER: $ A AUTOMOBILE LU\BWTY ISA H25549211 04/01/2021 04/01/2022 (Ea accident) COMBINED SINGLE LIMIT $ 1,000,000 — - 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) • $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB 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 ANYPROPRIETOR/PARTNER/EXECUTIVE YN/A E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBEREXCLUDED? ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 It 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 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 Left Abutment Erodibility Study; 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. This insurance is primary and non-contributory over an 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 ......-..-- I ©1988.2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 0002158 SP 0129 -C01-P02159-1 City of Ashland Attention: Pieter Smeenk 20 East Main Street Ashland,OR 97520 0129-01-00-0002158-0001-000495114 AGENCY CUSTOMER ID: CN101348564 LOC#: Los Angeles ACO ADDITIONAL 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 • SCF 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 0129-01-00-0002158-0002-0004952 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 delivery and 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 CCW 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) a 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 CCN please respond to USOoerations.email@marsh.com with the Certificate number and we will inactive the record inour system to avoid future automatic delivery. Thank you. US Operations, Marsh USA, Inc.