HomeMy WebLinkAboutInsurance Certificate: Ch2M Hill Engineers, Inc. 0
DATE(MMIDDIYYYY)
AC40RD CERTIFICATE OF LIABILITY INSURANCE 05/28/2026
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
a 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). w
PRODUCER LIC #0437153 1-212-948-1306 CONTACT y'
NAME: w
Marsh Risk & Insurance Services PHONE FaX 1-212-948-1306 O
CIRTS_Support@jacobs.com E-MAIL AfC No:
633 W. Fifth Street ADDRESS:
INSURERS AFFORDING COVERAGE NAIC#
Los Angeles, CA 90071 USA INSURERA:ACE AMER INS CO 22667
INSURED INSURERB: INDEMNITY INS CO OF NORTH AMER 43575 °v
CH2M HILL ENGINEERS, INC. INSURERC: Z
W
C/O Global Risk Management INSURER D:
515 South Flower St., Suite 4800 INSURERE:
Los Angeles, CA 90071 USA INSURERF:
COVERAGES CERTIFICATE NUMBER:752688825 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.
ADDL —POLICY EFF POLICY
INSR TYPE OF INSURANCE INSD SUER POLICY NUMBER MMIDNYYY MMI DI EXP
LTR LIMITS
A X COMMERCIAL GENERAL LIABILITY HDO G4938788A 07/01/26 07/01/27 EACH OCCURRENCE $ 7,000,000
DAMAGE TO RE
CLAIMS-MADE [X]OCCUR PREM SES Ea occuE ence $ 500,000
X CONTRACTUAL LIABILITY MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 7,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000
X' POLICY a PEA D LOC PRODUCTS-COMP/OPAGG $ 10,000,000
OTHER: I 1 1 $
A AUTOMOBILE LIABILITY ISA H08891990 07/01/26 07/01/27 COMBINED SINGLE LIMIT $ 2,000,000
Ea accident
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTYDAMAGE
AUTOS ONLY P
AUTOS ONLY Per accident) $ _
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
B AND EMPS YERS'LIATIONILIT WLR C7280918A (AOS) 07/01/26 07/01/27 X STATUTE ERH
AND EMPLOYERS'LIABILITY
A ANYPROPRIETOR/PARTNER/EXECUTIVE N NIA SCF C72809191 (WI) 07/01/26 07/01/27 E.L.EACH ACCIDENT $ 1,000,00
OFFICERIMEMBEREXCLUE
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A PROFESSIONAL LIABILITY EON G21655065 017 07/01/26 07/01/27 PER CLAIM/PER AGG 2,000,000
DESCRIPTION OF OPERATIONS i LOCATIONS t VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space is required)
LOCATION: Englewood, CO. CONTRACT ADMINISTRATOR: Kim Neal. 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 POLICY SHALL BE PRIMARY
AND NON-CONTRIBUTORY AND IS LIMITED TO THE LIABILITY RESULTING FROM THE NAMED INSURED'S OWNERSHIP AND/OR OPERATIONS.
GENERAL LIABILITY INCLUDES CONTRACTUAL LIABILITY SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. FOR STATE . *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: SCOTT A. FLEURY
20 EAST MAIN STREET AUTHORIZED REPRESENTATIVE
ASHLAND, OR 97520
USA
Q 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Cert_Renewal
752688825
SUPPLEMENT TO CERTIFICATE OF U DATE
05/28/2026
NAME OF INSURED: CH2M HILL ENGINEERS, INC.
a
w
O
r�
N
w
SUPP(10/00)
DATE(MMIDDrr M)
05/28/2026
AC`401?0 CERTIFICATE OF LIABILITY INSURANCE
AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED R S THE
AUTHOR 2POLICIES
ED
THIS CERTIFICATE IS ISSUED AS A MATTER OF ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY
a BELOW. THIS CERTIFICATE OF I AND THECE CERTIFIC NOT ATE HOLDER.CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE ( },
REPRESENTATIVE OR PRODUCER, provisions or be endorsed.
IMPORTANT: If the certificate holder
is an
to the termsINSURES the
the licy policy,certain policies DmaOyNequirNe an endorsement. A statement on w
If SUBROGATION 15 WAIVED,subject �
this certificate does not confer rights to the certificate holder in lieu of such CONTACTndorsement(s).
1-212-948-1306 NAME: FAX 1-212-948-1306 ry
PRODUCER LIC #0437153 PHONE AIC No:
Marsh Risk & Insurance Services E-MAIL
CIRTS_Support@jacobs.Com ADDRESS: NAIL
633 W. Fifth Street INSURERS AFFORDING COVERAGE
22667 rn
INSURERA:ACE AMER INS CO
Los Angeles, CA 94071 USA 43575
INSURERB: INDEMNZTY INS GO OF NORTH AMER INSURED �W
ERC
CH2M HILL ENGINEERS, INC. INSURER
INSURER D:
C/O Global Risk Management INSURERE:
515 south Flower St., Suite 4800 INSURERF:
Los Angeles, CA 90071 USA 752684783 REVISION NUMBER:
OD
COVERAGES CERTIFICATE NUMBER: OVE FOR THE POLICY
NT W
THIS IS TO CERTIFY THAANDING ANY'ES OF REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT
O TR CT R OT BED HEREHER IN
IS SUBJECT TOTALO THE TERMS,
INDICATED. NOTWITHST
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED LIMITS
POLICY EFF POLICY EXP
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID,CLAIMS.Y EX
ADDLSUSR POLICY NUMBER MMIDDIYYYY 7,000,000
I`R TYPE OF INSURANCE 07/01/26 07/01/27 EACHOCCURRENCE $
HDO G4938788A D MAGETORENTED $ 500_000
A X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence
CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 5,400
$ 7,400,000
X CONTRACTUAL LIABILITY PERSONAL&ADV INJURY
_ GENERAL AGGREGATE $ 10,000,000
000 000
GEM%AGGREGATE LIMIT APPLIES PER'
PRODUCTS-COMPtOPAGG $ 14, ,
PRO- ❑LOC $
X POLICY❑JECT
07/01/26 07/01/27 COMBINED SINGLE LIMIT $ 2,Q00,000
OTHER: ISA H08891990 Ea accident
A AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ _
X ANY AUTO BODILY INJURY(Per accident) $
OWNED SCHEDULED PROPERTYDAMAGE $ _
AUTOS ONLY AUTOS Per accident
HIRED NON-OWNED $
AUTOS ONLY AUTOS ONLY
EACH OCCURRENCE $
UMBRELLA LIAB OCCUR AGGREGATE $ --
EXCESS LIAa CLAIMS-MADE $
OTH-
DED RETENTIONS 07/01/26 07/01/27 X PER
ER
WORKERSCOMPENSATION WLR C7280918A {ADS) 1,400,000
B AND EMPLOYERS'LIABILITY YIN scF C72809191 (WI) 07/01/26 07/41/27 E.L.EAEASE- AE $
A OFFICE /MEMB RIPARTNERIEXECUTIVE N 1 A
E.L.DISEASE-EA EMPLOYEE $ 1,000,000
(Mandatory In EREXCLUDED? 11000,000
(Mandatary in NH) E.L.DISEASE-POLICY LIMIT $
If yes,desc be under 07/01/27 PER CLAIM/PER AGG 2,000,000
DESCRIPTION OF OPERATIONS below EON G21655065 017 07/01/26
A PROFESSIONAL LIABILITY
ed if more space is
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AM=NISTRATORD iiiii,Additional Remarks Schedule,mayDarin Williams.e RE: WastewaterTreatment Plant Outfall Relocation
LOCATION: Englewood, CO. CONTRACTof Ashland, Oregon, and its elected officials, officers and
Preliminary Design and Permitting (Phase 1) The City
the above General Liability and Auto policies shall be primary
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
CE WILL NOT EXCEED OR BROADEN IN ANY WAY
and non-contributory and LIB=TBdPROVIDEDI1UNDERr THIS eCERTIFICATE OFhINSURAN named insured's ownership and/or operations.
*THE TERMS, CONDITIONS, AND
THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE C LLAT CONTRACT.*
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE
City of Ashland
ACCORDANCE WITH HDAT POLICY THEREOF,
PROVISIONS.E WILL BE DELIVERED IN
ATTN: Paula Brown AUTHORIZED REPRESENTATIVE
20 East Main Street
Ashland, OR 97520 USA
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
Cert_Renewal
752684783
ME
SUPPLEMENT TO CERTIFICATE
LATE INSURANCE ®ATE
NAME a OF INSURED: 05/28/2026 CH2M HILL ENGINEERS, INC.
W
w
a
N
h
N
W
SUPP(10/00)