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HomeMy WebLinkAboutPW14-052 - Insurance Certificate - Environmental Science Associates - 01/01/2016 - 01/01/2017 Liability Coverage - 12/22/2015 ACC CERTIFICATE OF LAB LITY INSUR,A� i�E PATEIMMIADfYYYY, 1 12/22/2015 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 endorsements. ,'..PRODUCER CONTACT NAME Jaclyn Grewohl-.Woodruff-Sawyer&Co. PHONE . - mmm FAX 50 California Street, Floor 12 IArc i N.E t) 415-391 2141 _ _I t lv.as 415 989-9923_ E-MAIL San Francisco CA 94111 �DDREs:19rewohl wsandco.com _ AFFORDING COVERAGE N'AIC# .. INSURERA:Greenwich Insurance Company �22322 INSURED ENVISCI-01 INSURER B:XL S eclalt f Insurance Company _ ;37885 Environmental Science Associates INSURER C 550 Kearny Street, Ste 800 San Francisco'CA 94108 INSURER D INSURER E: �� INSURER F�. .�. . COVERAGES CERTIFICATE NUMBER:538272896 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. ILTR TYPE OF INSURANCE ^ NSD VVVO POLICY NUMBER MNI1DDIYYYY PAMIDDri"YYY... LIMITS.. A X. COMMERCIAL GENERAL LIABILITY Y GECO01335713 1/1/2016 1/112017 EACH S1.,000,000 _._... _ . ......_...._..w.�.__._.......m.._. ..�.''., . CLAIMS-MADE FIX 1 OCCUR PREMISES(Ea otccurrrence ____ 51,000,000 X Contractual Liab MED EXP(Any one person) S5,000 X Stop Gap PERSONAL&ADV INJURY 51,000,000 GENT AGGREGATE LIMIT APPLIES,PER: ..GENERAL AGGREGATE $2.,000,000 �. � .I.__. _._.._..._...- .._._........_ .,_....._ ...__...m .m..,_..... POLICY X I JECT t.__.__J LOC l PRODUCTS-COMP/OP AGG $2.,000,000 X j OTHER. No Deductible j S C MBINESI SINGLE LIMI 1 000,000 B AUTOMOBILE LIABILITY �AECO01336513 �1/1/2018' 1/V2017 (Ea accident) �S X ANY AUTO BODILY INJURY(Per person) S �....m.._......ALL OWNED SCHEDULED ALTOS _- ALTOS BODILY INJURY(Per accident)y S� HIRED AUTOS X NON-OWNED (Per accident) DAMAGE ALTOS !�� Per accidend) M X No Ded. S B X UMBRELLA LIAR X OCCUR UEC001336613 11/112016 11112017 EACH OCCURRENCE S1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE y S,1,000 000 DED '..'RETENTIONS $ B WORKERS COMPENSATION WECO01337413 11112016 11112017 X PER I OTH- AND EMPLOYERS'LIABILITY V, STATUTE k I ER YIN ANY PROPRIETOR)PARTNERfEX:ECUTIVE F--1 N/A III E.L.EACH ACCIDENT S1,000,000 OFFICERIMEMBER EXCLUDED? DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIh41T $1,000,000 (Mandatory in NH E.L bISEASE-EA EMPLOYE If yes,describe under - - - $1,000,000 B Professional Liability PECO01336813 111/201,6 1/1/2017 Each Occurrence: $1,000,000 Cuv.A.Claims Made Aggregate: $2,000,000 Retry Date:1011/89 Retention: $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,,Additional Remarks Schedule,may be attached,if more space is required) 2005118.0, Kent-South 224th Street Extension. As respects Commercial General Liability,The City of Kent is named Additional Insured as per attached forms XIL 2037 07 04(Ed. 0413)&XIL 2010 07 04(Ed.0413). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Larry Blanchard 220 4th Ave South AUTHORIZED REPRESENTATIVE Kent WA 98032 0a I 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Fw _05-1 This endorsement, effective 12:01 a.m., January 1, 2016 forms a part of Policy No. GECO01336713 issued to ENVIRONMENTAL SCIENCE ASSOCIATES by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS— SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Location(s)Of Covered Operations Person s Or Organization s : ANY PERSON OR ORGANIZATION THAT YOU ARE Various REQUIRED IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT TO INCLUDE AS AN ADDITIONAL INSURED PROVIDED THE `BODILY INJURY"OR "PROPERTY DAMAGE"OCCURS SUBSEQUENT TO THE EXECUTION OF THE WRITTEN CONTRACT OR WRITTEN AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage"or"personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury"or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or XIL 2010-0704 (Ed.0413) ©2013,XL America, Inc. Page 1 of 2 All rights reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission BVIE 02/11/2015 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions of this policy remain unchanged. XIL 2010-0704 (Ed. 0413) O 2013, XL America, Inc. Page 2 of 2 All rights reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission BVIE 02/11/2015 This endorsement, effective 12:01 a.m., January 1, 2016 forms a part of Policy No. GECO01336713 issued to ENVIRONMENTAL SCIENCE ASSOCIATES by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS—COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Location And Description Of Completed Operations Persons Or Organ ization s : ANY PERSON OR ORGANIZATION THAT YOU ARE Various REQUIRED IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT TO INCLUDE AS AN ADDITIONAL INSURED PROVIDED THE `BODILY INJURY"OR"PROPERTY DAMAGE"OCCURS SUBSEQUENT TO THE EXECUTION OF THE WRITTEN CONTRACT OR WRITTEN AGREEMENT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury"or"property damage"caused, in whole or in part, by"your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". All other terms and conditions of this policy remain unchanged. XIL 2037-0704 (Ed.0413) ©2013,XL America, Inc. Page 1 of 1 All rights reserved. May not be copied without permission. Includes copyrighted material of Insurance Services Office, Inc., with its permission BVIE 02/11/2015