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HomeMy WebLinkAboutInsurance Certificate: URS Energy & Construction Inc A CERTIFICATE OF LIABILITY INSURANCE DA 17/29/1011 29011 UIYYYY) 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 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 81NSURANCE SERVICES NAME: 345 CALIFORNIA STREET,SUITE 1300 PHONE FA/C No IAIC NQ,EAU, CALIFORNIA LICENSE NO.0437153 E-MAIL SAN FRANCISCO,CA 94104 ADDRESS: INSURE S AFFORDING COVERAGE NAIC0 URSCOR-ALL-PROF-12-13 BEL Hasler NOC INSURER A:National Union Fire Ins Co Pittsburgh PA 19445100 INSURED INSURER B:Zurich American Insurance Company 16535100 URS Energy 8 Construction,reef,Suite Inc. 10900 NE 881.Street,Suite 500 INSURER C:Illinois National Ins Co 23817001 Bellevue,WA 98004 INSURER D: Insurance Company Of The Slate Of PA 19429100 INSU13URER E: Lexraglan Insurance Company 19437000 URER F: Lloyd's Of London 8 Bdfish Companies 15792004 COVERAGES CERTIFICATE NUMBER: SEA-002290786-02 REVISION NUMBER:2 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 ADD L SUER POLICY NUMBER M/DD/YYYY MM LTR IDD/YYYY LIMITS A GENERAL LIABILITY X GL4870829 05101/1011 0610112012 EACH OCCURRENCE $ 2,000.000 AMA X COMMERCIALGENERALUABILHY PREMISES T(E..RENTED...) $ 1,000,000 CLAIMS-MADE 1XI OCCUR MED EXP(Any and peraxi S 10,060 X XCU,BFPD PERSONALS ADV INJURY $ 2,600,000 X Contractual Liability GENERAL AGGREGATE S 2.666,666 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2.000,000 POLICY -X] PRO- LOC $ IFCT B AUTOMOBILE LIABILITY X BAP938521502 090112011 06/0112012 COMBINED SINGLE LIMIT 2,666,666 Ea accident X MY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) E NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccidem S UMBRELLA LUIS OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMST.IADE AGGREGATE $ OED I I RETENTION$ It A WORKERS COMPENSATION SEE ATTACHED-ACORD 101 01/0112012 01/01/2013 X1 WC STAru- I OTH- AND EMPLOYERS'LIABILITY ER D ANY PROPRIETORIPARTNER/EXECUTIVE YIN SEE ATTACHED-ACORD 101 61/6112012 61161/2613 E.L.EACH ACCIDENT $ 2'000'000 D (Mandatory InN REXCLUDED? NIA SEE ATTACHED-ACORD 101 01/01/2012 0110112013 2,600,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Prof.Liab wlLmtd Contractual T1,i5,4380M 0901/2011 06/01/2012 Each Claim $1,000,000 F Claims made policy 051501PE1105490 090112011 0610112012 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ANach ACORD 101,Additional Remarks Schedule,Unions space Is required) Re:Engineering Services for the Hasler Dam Stability Analysis The City of Ashland,Oregon,and its elected officials,officers and employees are included as Additional Insureds as respects the General Liability and Automobile Liability policies,where required by written contract. Such insurance shall be primary insurance with respects to the interest of the additional insureds and any other insurance maintained by the additional insured shall be excess and not contriiuting/nth the nsurance required hereunder. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. LL- 5 2012 AUTHORIZED REPRESENTATIVE of Marsh Risk&Insurance Services Lynne Harrington ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: URSCOR LOC#: San Francisco A�® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH RISK&INSURANCE SERVICES URS Energy&Construction,Inc. 10900 NE 81h.Street,Suite 500 POLICY NUMBER Bellevue,WA 99004 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 The Workers Compensation coverage shown does net apply in monopolistic stales. In the States of ND,OH,WA and WY Workers'Compensalion coverage is provided by the State Fund. In those States,the above- referenced policies provide Stop Gap Employers Liability only. Workers Compensation policies apply as indicated below: Insurer A: National Union Fire Ins Go Pittsburgh,PA NAICtt 19445100 WC 021417576-CA WC 021417579 -TX Insurer D: Insurance Company Of The Stale Of PA NAICN 19429100 WC 021417580-MA,WI(Stop Gap) WC 021417581 -AK AL,AR,AZ,CO,DE,GA,ID,KS,KY,MD,ME,MO,MS,MT,NC,NH,NM,NV,OK,OR,PA RI,SC,SO,TN,UT,VA,VT,WV WC 021417585-MN Insurer C: Illinois National Ins Co NAIC#23817001 WC 021417577-FL WC 021417578 -NY WC 021417582-CT,DC,HI,IA,IL,IN,LA,MI,NE,NJ ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MARSH Marsh Risk&Insurance Services 345 California Street,Suite 1300 San Francisco,CA 94104-2679 California Insurance License#0437153 886-769-3673 urs.renewalcerts@marsh.com www.marsh.com December 23, 2011 Dear Certificate Holder: Attached is an updated Certificate of Insurance which evidence URS's Workers Compensation program effective January 1, 2012. If you have any questions, please do not hesitate to contact us between 7am - 6pm (PST) as follows: Telephone: 1-888-769-3873 Email: urs.renewalcertsOmarsh.corn Sincerely, Marsh Certificate Team LEADERSHIP,KNOWLEDGE,SOLUTIONS...WORLDWIDE. COMPANIES LENNAN INSURER CANCELLATION TERMS NAMED INSURED: POLICY NO: URS Energy&Construction,Inc. Various HOLDER NAME: City of Ashland CANCELLATION TERMS: 30 Days Notice of Cancellation will be provided by the carriers in accordance with the policy terms and conditions in the event the policies are cancelled or non-renewed, for any reason other than non-payment of premiums. CANCELLATION TERMS APPLY TO THE FOLLOWING COVERAGES: GL,AL,WC and Professional Liab.