HomeMy WebLinkAboutWSP USA Inc. - Certificate of Liability InsuranceACo ® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
11 1 5/1/2023
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
NAME: AJG Service Team
Arthur J. Gallagher Risk Management Services, LLC PHONE FAX
300 Madison Avenue .(Arc Nc, Ext): 212-994-7100 Avc Ne : 212-994-7047
E-MAIL
28th Floor ADDRESS.: GGB.WSPUS.CERTREQUESTS@AJG.COM
New York NY 10017 mQiiPpat n ars:nci Nrdr-rnvraar.r nrerca
INSURED
WSP USA Inc.
One Penn Plaza
New York, NY 10119
INSURER ALiberty Insurance Corporation
WSPGLOB-01 INSURER B : Zurich American Insurance Compaq
INSURER D_
INSURER E :
COVERAGES CERTIFICATE NUMBER: 207043770R REVISION NUMBER:
42404
16535
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 SUBRPOLICY POLICY
LTR POLICY NUMBER MM/DNYYY M DYYYY LIMITS
B X COMMERCIAL GENERAL LIABILITY Y GLO9835819-10 5/1/2023 5/1/2024 EACH OCCURRENCE 3,500,000___
CLAIMS -MADE OCCUR PRE, SES Ea occur encel 3,500,000
MED EXP (Any one person) 10,000
PERSONAL & AD_V INJURY_ 3,500,000
AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 7,000,000GEN'L
X POLICY D PROJECT 0 LOC PRODUCTS - COMP/OP AGG 4,000,000
OTHER:
A AUTOMOBILE LIABILITY AS7-621-094060-033 5/1/2023 5/1/2024 COMBINED SINGLE LIMIT
Ea accident 5,000,000
BODILY INJURY (Per person) X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident)
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTYDAMAGE
Per accident)
UMBRELLALIAB OCCUR EACH OCCURRENCE
AGGREGATEEXCESSLIABCLAIMS -MADE
DIED - RETENTION $
A
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN.
ANYPROPRIETOR/PARTNER/EXECUTIVE N
WA7-62D-094060-013
WA7-62D-095609-073
WC7-621-094060-913
5/1I2023
5/1/2023
5/1/2023
5/1/2024
511/2024
5/112024
X STATUTE ERH
E.L. EACH ACCIDENT 2,000,000
OFFICER/MEMBER EXCLUDED? N/A Mandatory
in NH) E.L. DISEASE - EA EMPLOYEE_ 2,000,000_ If
yes, describe under DESCRIPTION
OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 2,000,000 DESCRIPTION
OF OPERATIONS 1 LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIRTY (
30) DAYS NOTICE OF CANCELLATION. Project
No.: 160413C I Lewis Street Overpass Constructability Review I Client project No.: 19037 The city shall be named as an insured under the Commercial General
Liability insurance policy with respect to the work performed for the City. City
of Pasco 525
N 3rd Avenue Pasco
WA 99301 SHOULD
ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLICY PROVISIONS. AUTHORIZED
REPRESENTATIVE 01988-
2015 ACORD CORPORATION. All rights reserved. ACORD
25 (2016/03) The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY)
5/1/2023
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
Arthur J. Gallagher Risk Management Services, LLC
300 Madison Avenue
28th Floor
New York NY 1001
1.Vn1:4' AJG Service Team
PHONE FAX
AfC, No. Ext); 212-994-7100 fA/C. Not:
ADDRESS: GGB.WSPUS.CERTREQUESTS JG.COM
INSURER(p AFFORDING COVERAGE
INSURER A: Liberty Insurance Corporation
INSURED WSPGLOB-01
WSP USA Inc.
One Penn Plaza
New York, NY 10119
INSURERS: Zurich American Insurance Company
INSURERC:
INSURER D :
INSURER E :
COVERAGES CERTIFICATE NUMBER:1220060433 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 ADD L UBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE Wv0 POLICY NUMBER DD/YYYY MWDD/YYYY LIMITS
B X COMMERCIAL GENERAL LIABILITY Y Y GLO9835819-10 5/1/2023 5/1/2024 EACH OCCURRENCE 3.500,DOD
CLAIMS -MADE T OCCUR DAMAGE TO RENTED
PREMISES (Ea occurrence) 3,500,000
MED EXP (Any one person). 10,000
PERSONAL &ADV INJURY 3,500,000
AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 7,000,000GENT
X POLICY PROJECT LOC PRODUCTS - COMP/OP AGG 4,000,000
OTHER:
A AUTOMOBILE LIABILITY AS7-621-094060-033 5/1/2623 5/112024 COMBINED SINGLE LIMIT
Ea accident 5,000,000
X BODILY INJURY (Per person) ANY AUTO
1AUTOSOWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY (Per accident)
PROPERTYDAMAGE
Per accident
HIRED NON -OWNED
ONLY AUTOS ONLY
UMBRELLALIAS OCCUR EACH OCCURRENCE
AGGREGATEEXCESSLIABCLAIMS -MADE
DED RETENTION S
A
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE N
WA7-62D-094060-013
WA7-62D-095609-073
WC7-621-094060-913
5l1/2023 5/1l2024
5/1/2023 5/112024
5/1/2023 5/1/2024
X SEATUTE ERH
E.L. EACH ACCIDENT 2,000,000
OFFICER/MEMBEREXCLUDED? N/A
E.L. DISEASE - EA EMPLOYEE 2,000,000MandatoryinNH)
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
THIRTY (30) DAYS NOTICE OF CANCELLATION.
RE: Project Number: 31404486.000 ( Project Description: PROVIDE CONSTRUCTION MANAGEMENT AND CM SERVICES FOR THE CITY OF PASCO'S
ZONE 3 STORAGE RESERVOIR I AID-22-094391 CITY OF PASCO, WASHINGTON is Additional Insureds as respects General Liability policy, pursuant to and
subject to the policy's terms, definitions, conditions and exclusions. The insurance provided in the General Liability policy is primary and any other insurance
shall be excess only, and not contributing. Waiver of Subrogation applies to Additional Insureds, as respects General Liability policy, pursuant to and subject to
the policy's terms, definitions, conditions and exclusions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
CITY OF PASCO, WASHINGTON
525 N THIRD AVE
PASCO WA 99301
AUTHORIZED REPRESENTATIVE
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Arthur J. Gallagher Risk Management, Services; LLC
300 Madison Avenue, 28th Floor.
New York NY 10017
MDG2023 00032655 01
II"III'IIII'III'Illl"IIIIIIIIIi IIil"IiI'IIIIII'lll"II'I'III
CITY OF PASCO, WASHINGTON
525 N THIRD AVE
PASCO, WA 99301