Loading...
HomeMy WebLinkAboutABM Industry Groups, LLC - Certificate of Liability InsuranceSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Willis Towers Watson Southeast, Inc. c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA ABM Industry Groups, LLC an ABM Industries Incorporated Company 4151 Ashford Dunwoody Road, Suite 600 Atlanta, GA 30319 SEE ATTACHED City of Pasco 525 N. 3rd Avenue Pasco, WA 99301 05/19/2023 1-877-945-7378 1-888-467-2378 certificates@willis.com ACE American Insurance Company 22667 ACE Property & Casualty Insurance Company Indemnity Insurance Company of North Ameri 20699 43575 Federal Insurance Company 20281 AIG Specialty Insurance Company 26883 American Home Assurance Company 19380 W29001623 A 2,000,000 2,000,000 Excluded$1,000,000 SIR XCU 2,000,000 6,000,000 2,000,000 Y Y XSL G47300198 11/01/2022 11/01/2023 A 5,000,000 11/01/202311/01/2022YYISA H10691825 B 10,000,000 0 Y Y XEU G27910865 008 11/01/2022 11/01/2023 10,000,000 WLR C50677370CY 1,000,000No11/01/2022 11/01/2023 1,000,000 1,000,000 D Crime/Employee Dishonesty/ Fidelity Each OccurrenceJ0610579811/01/2022 11/01/2023 298290924161974SR ID:BATCH: $5,000,000 Willis Towers Watson Certificate Center Page 1 of 3 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: ABM Industry Groups, LLC an ABM Industries Incorporated Company 4151 Ashford Dunwoody Road, Suite 600 Atlanta, GA 30319 The City is included as an Additional Insured as respects General Liability and Automobile Liability (Umbrella follows Form) as required by written contract with the Named Insured. If required by the written contract or agreement with said Additional Insured, this insurance shall be primary insurance to any other insurance available to said insured covering the same loss. Such other insurance available to said Additional Insured shall be excess to and non-contributing to this insurance. Waiver of subrogation applies in favor of Additional Insured as respects General Liability, Automobile Liability and Workers Compensation, where allowed by law, (Umbrella follows form) as required by written contract with the Named Insured. Umbrella/Excess policy applies excess of General Liability, Auto Liability and Employers Liability Policies. INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: MPB G23645233 016 EFF DATE: 07/01/2022 EXP DATE: 07/01/2023 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Professional LIability Each Claim/Aggregate $5,000,000 Aggregate $5,000,000 Retention $1,000,000 INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: WCU C50677254 EFF DATE: 11/01/2022 EXP DATE: 11/01/2023 SUBROGATION WAIVED: Y TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Workers Compensation EL Each Accident $1,000,000 WC-Statutory/CA-$1M SIR EL Disease-Pol Limit $1,000,000 OH, WA, OR, IL, MI - $500K SIR EL Disease-Each Empl $1,000,000 ADDITIONAL REMARKS: ANY PROPRIETOR/PARTNER/EXECUTIVE/ OFFICER/MEMBER are included under Excess Workers Compensation policy #WCU C50677254 INSURER AFFORDING COVERAGE: AIG Specialty Insurance Company NAIC#: 26883 POLICY NUMBER: CPO 16081985 EFF DATE: 05/01/2023 EXP DATE: 05/01/2024 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Contractor's Pollution Liability Each Loss $10,000,000 Aggregate $10,000,000 SIR $500,000 2 3 Willis Towers Watson Southeast, Inc. See Page 1 See Page 1 See Page 1 See Page 1 25 Certificate of Liability Insurance W29001623CERT:2982909BATCH:24161974SR ID: ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: ABM Industry Groups, LLC an ABM Industries Incorporated Company 4151 Ashford Dunwoody Road, Suite 600 Atlanta, GA 30319 INSURER AFFORDING COVERAGE: American Home Assurance Company NAIC#: 19380 POLICY NUMBER: 080768613 EFF DATE: 05/01/2023 EXP DATE: 05/01/2024 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Property Coverage Per Policy $5,000,000 ADDITIONAL REMARKS: All Risk of Physical Damage at any location including customer's premises, subject to policy terms. INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: ISA H10691825 EFF DATE: 11/01/2022 EXP DATE: 11/01/2023 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Garage Keepers Legal Liability Limit $2,000,000 ADDITIONAL REMARKS: Automobile Liability includes Excess Garage Keepers Liability. 3 3 Willis Towers Watson Southeast, Inc. See Page 1 See Page 1 See Page 1 See Page 1 25 Certificate of Liability Insurance W29001623CERT:2982909BATCH:24161974SR ID: BLANKET ADDITIONAL INSURED MS-309963.2 (11/20)©Chubb. 2016. All rights reserved.Page 1 of 1 Named Insured ABM Industries Incorporated Endorsement Number 26 Policy Symbol XSL Policy Number G47300198 Policy Period 11/01/2022 TO 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: EXCESS COMMERCIAL GENERAL LIABILITY POLICY Any person or organization whom you have agreed to include as an additional insured in a written contract is included as an additional insured under this policy, but only to the extent required by and in accordance with the terms of such written contract executed prior to loss, provided that written contract does not specify an ISO endorsement or other specific wording, and only with respect to liability for “bodily injury”, “property damage”, or “personal and advertising injury” arising out of your ongoing or completed operations. 1 XS-20288a (05/14)©Chubb. 2016. All rights reserved.Page 1 of 1 NON-CONTRIBUTORY ENDORSEMENTFOR ADDITIONAL INSUREDS NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured ABM Industries Incorporated Endorsement Number 8 Policy Symbol XSL Policy Number G47300198 Policy Period 11/01/2022 to 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY Schedule Organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non- contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in, the sch edule shall r ead: “All persons or entities added as additi onal insureds through an endorsement with the term “Additional Insured”in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to Secti on IV.4: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the “Additional Insured”)for a loss we cover under this policy,this insurance will apply to such loss and is primary (subject to satisfaction of the “retained limit”),meaning that we will not seek contribution from the other insurance available to the Additional Insured.Your “retained limit”still applies to such loss,and we will only pay the Additional Insured for the “ultimate net loss”in excess of the “retained limit”shown in the Declaratio ns of this policy. Authorized Representative 1 XS-6W34a (02/20)Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO USWAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured ABM Industries Incorporated Endorsement Number 5 Policy Symbol XSL Policy Number G47300198 Policy Period 11/01/2022 to 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization:Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against the person(s)or organization(s)shown in the Schedule above because of payments we make under this policy.Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s)or organization(s)prior to loss.This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. All Other Terms And Conditions Remain Unchanged. Authorized Representative 2 DA-9U74c (03/16)Page 1 of 1 ADDITIONAL INSURED – DESIGNATED PERSONS OR ORGANIZATIONSADDITIONAL INSURED – DESIGNATED PERSONS OR ORGANIZATIONS Named Insured ABM Industries Incorporated Endorsement Number 3 Policy Symbol ISA Policy Number H10691825 Policy Period 11/01/2022 TO 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s):Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. A.For a covered “auto,” Who Is Insured is amended to include as an “insured,” the persons or organizations named in this endorsement.However, these persons or organizations are an “insured” only for “bodily injury” or “property damage” resulting from acts or omissions of: 1.You. 2.Any of your “employees” or agents. 3.Any person operating a covered “auto” with permission from you, any of your “employees” or agents. B.The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized Representative 2 DA-21886b (06/14)Page 1 of 1 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDSNON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured ABM Industries Incorporated Endorsement Number 2 Policy Symbol ISA Policy Number H10691825 Policy Period 11/01/2022 TO 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM Schedule Organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non- contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in, the schedule shall read: “All persons or entities added as additional insureds through an endorsement with the term “Additional Insured” in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to the Other Insurance Condition under General Conditions: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the “Additional Insured”)for a loss we cover under this policy,this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. Authorized Representative 2 DA-13115a (06/14)Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERSWAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Named Insured ABM Industries Incorporated Endorsement Number 1 Policy Symbol ISA Policy Number H10691825 Policy Period 11/01/2022 TO 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIERS COVERAGE FORM AUTO DEALERS COVERAGE FORM We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto.The waiver applies only to the person or organization shown in the SCHEDULE. SCHEDULE Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Authorized Representative Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number Policy Number Symbol: Number: Policy Period TO Effective Date of Endorsement Issued By (Name of Insurance Company) Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/05) Ptd. U.S.A. Copyright 1982-83, National Council on Compensation ABM INDUSTRIES INCORPORATED ONE LIBERTY PLAZA, 7TH FLOOR NEW YORK NY 10006 WLR C50677370 11-01-2022 11-01-2023 11-01-2022 INDEMNITY INS. CO. OF NORTH AMERICA ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. 3 WC 99 04 91 (10/08)Page 1 of 1 RECOVERY FROM OTHERSRECOVERY FROM OTHERS Named Insured ABM Industries Incorporated Endorsement Number 2 Policy Symbol WCU Policy Number C50677254 Policy Period 11/01/2022 to 11/01/2023 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Specific Excess Workers Compensation and Employer’s Liability Policy Solely with respect to a written contract with the organization named in the Schedule below,the final paragraph of I. Recovery From Others in PART SIX - CONDITIONS is deleted and replaced with the following: In the event of any payment under this policy for a Loss for which you have waived the right of recovery in a written contract entered into prior to the Loss,we hereby agree to also waive our right of recovery but only with respect to such Loss and only for the organization named in the Schedule below. SCHEDULE Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. This endorsement does not apply to policies in Missouri where the employer is in the construction group of classifications. Authorized Representative Willis 102 WILLIS TOWERS WATSON CANCELLATION NOTICE POLICY NO. All policies listed on the enclosed certificate NAMED INSURED ABM Industry Groups, LLC EFFECTIVE DATE SEE PAGE 1 Holder Name: City of Pasco 525 N. 3rd Avenue Pasco, WA 99301 Project: See Page 1 Cancellation Terms: IN ADDITION TO THE NOTICE PROVISIONS IN THE POLICY, WILLIS TOWERS WATSON HAS AGREED WITH THE CARRIER THAT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, WILLIS TOWERS WATSON WILL SEND WRITTEN NOTICE TO THE CERTIFICATE HOLDER WITHIN 30 DAYS EXCEPT FOR NONPAYMENT OF PREMIUM. WILLIS TOWERS WATSON WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED. Cancellation Terms Apply to the Following Coverages: All policies listed on the enclosed certificate