Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Certificate of Liability Insurance
pT /� p y T�/ w��+ p/� �+C CERTIFICATE IFICATE of LIABILITY H INSURANCE Page 1 of 2 01/28/2013) 1/28/20 3) 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 Willis Of New York, Inc. PHONE FAX c/o 26 Century Blvd. (NC.NO.EXT)- 877-945-7378 (BLCCNO). 888-467-2378 P. O. Box 305191 E-MAIL Nashville, TN 37230-5191 -ADDRESS- certificates@willis.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Greenwich Insurance Company 22322-001 INSURED Atkins North America, Inc. INSURERB: XL Specialty Insurance Company 37885-001 2001 NW 107th Avenue INSURER C:Underwriter's at Lloyds 15792-001 Miami, FL 33172-2507 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:19304546 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. IN SR I TYPE OF INSURANCE !ADD'L SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS NSRd A GENERAL LIABILITY Y CGG740901601 4/1/2012 4/1/2013 EACH OCCURRENCE IS 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence IS 300 000 CLAIMS-MADE OCCUR MED EXP(Anyone person) I5 10,000 X Contractual Liability PERSONAL&ADV INJURY IS 1,000,000 GENERALAGGREGATE S 2,000,000 GIWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG S 2,000,000 POLICY 7XI PRO- X LOC 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) S ANYAUTO BODILY INJURY(Per person) S ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS NON-OWNED PROPERTYDAMAGE AUTOS (Per accident) $ S HUMBRELLALIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I (RETENTION$ IS B WORKERS COMPENSATION CWG740901501 4/1/2012 4/1/2013 X WC TATU- I IIOTH- AND EMPLOYERS'LIABILITY TORY_LIMITSJ.�LER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT IS 1,0001000 OFFICERIMEMBER EXCLUDED? ftndatoryin NH) E.L.DISEASE-EA EMPLOYEE Is 1,000,000 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT IS 1,000,000 C Professional B080111209P12 4/1/2012 4/1/2013 $1,000,000 Each Claim & Liability-Claims Made $1,000,000 Annual Aggregate 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach Acord 101,Additonal Remarks Schedule,if more space is required) Effective April 1, 2011, Post, Buckley, Schuh & Jernigan, Inc., d/b/a PBS&J changed its name officially to Atkins North America, Inc. Greenwich Insurance Companies Best Rating A XV XL Specialty Insurance Company Best Rating A+ XV Underwriters at Lloyd's London AM Best Rating: A XV. Professional Liability policy written on claims-made basis. 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 Miami Beach City's Manager's Office AUTHORIZED REPRESENTATIVE Attn: Jorge Gomez, Assistant City Manager t 1700 Convention Center Drive /* Miami Beach, FL 33139 Coll:3989469 Tpl:1436747 Cert:19304546 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 33004588 LOC#: ADDITIONAL REMARKS SCHEDULE Page-2-of _2— AGENCY NAMED INSURED Atkins North America, Inc. Willis of New York, Inc. 2001 NW 107th Avenue POLICY NUMBER Miami, FL 33172-2507 See First Page CARRIER NAIC CODE See First Page EFFECTIVEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE There are no Deductibles or Self-Insured Retentions on the General Liability and Workers Compensation. RE: PROFESSIONAL ENGINEERING SERVICES ON AN "AS-NEEDED BASIS" TO PROVIDE CONSTRUCTION MANAGEMENT SUPPORT FOR RIGHT-OF-WAY CAPITAL IMPROVEMENT PROJECTS, RESOLUTION NO. 2012-27979 City of Miami Beach, Florida is included as an Additional Insured as respects General Liability. ACORD 101 (2008/01) Coll:3989469 Tpl:1436747 Cert:19304546 ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CGG740901601 COMMERCIAL GENERAL LIABILITY CG 02 24 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days'Notice 90 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than Policy Condition or as amended by an applicable nonpayment of premium, the number of days state cancellation endorsement, is increased to the required for notice of cancellation, as provided in number of days shown in the Schedule above. paragraph 2.of either the CANCELLATION Common CG 02 24 10 93 Copyright,Insurance Services Office,Inc.,1992 Willis Limited FINEX Global Willis IJMR:H0801112091`12 Insured_WS Atkins Pic Type of Risk:Insurance of: Primary Professional Indemnity Insurance Period:1 Aori 12012 to 31 March 2013 4.12 Cancellation .If INSURERS cancel this policy prior to its expiry date by notice to the INSURED for any reason,INSURERS will send written notice of cancellation to the persons or organizations listed in the schedule to be created and maintained by the INSURED (the"Cancellation Notice Schedule")at least 30 days prior to the cancellation date applicable to the policy.This notice will be in addition to any notice to the INSURED. The INSURED will provide an updated copy of the Cancellation Notice Schedule to Insurers on a monthly basis. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s)or organization(s)named in the Cancellation Notice Schedule in the event of a pending cancellation of coverage. INSURERS have no legal obligation of any kind to any such person(s)or organization(s). Any failure to provide advance notice of caucellation to the person(s)or organizatiou(s)named in the Cancellation Notice Schedule will impose no obligation or liability of any kind upon INSURERS,will not extend any policy cancellation date and will not negate any cancellation of the policy. , INSURERS are not responsible for verifying any information in any Cancellation Notice Schedule,nor are INSURERS responsible for any incorrect information that the INSURED may use. Willis Limited W LM OS01 I Willis Intemal Ref 0001 Willis Limited FMX Global Willis .RLSK DETAILS UNIQUE MARKET REFERENCE: B080111209Pi2 TYPE: Primary Professional Indemnity Jnsurauce INSURED: A) N S Atkins plc formerly W S Atkins Ltd and/or Associated and/or Subsidiary Companies and Partnerships including but not limited to Faithful+Gould(formerly Hanscomb Faithful &Gould)and the Houston,Texas office of MSL Engineering Ltd and as more folly defined herein but excluding the entities lister]as INSURED B). B) The Atkins North America Holdings Corporation which is comprised of the following entities: Atkins North America Inc; Atkins Michigan Inc; Atkins,P.A.; Peter R Brown Conshudion,Inc; Atkins Caribe,LLP;and the eutities formerly known as: The PBSJ Corporation Post,Buckley,Schuh&Jernigan,Inc.doing business as PBS&J PBS&J,P.A. PBS&J Canlro Engineering,C.S.Y. PBS&J Constructors,Too. PBW Intemational,Inc. PBS&J Construction Services,Inc. Seminole Development Corporation Post Buckley de Argentina S.A. John Powell&Associatrs,Inc John Powell&Associates John Powell&Associates,a Solo Proprietor Durham Technologic.,Ion. Welker&Associates Tri-Line Associates,Inc. W.Koo&Associates,Inc. Croslin&Associates,Inc. Land&water Consulting EIP Associates Eco Science Corporation Peter Brown Coostructiou,Inc. PBS&J Canbe,LLP and/or Associated and/or Subsidiary Companies and Parltlershipa and as more fully defined herein." Pago 1 1303011r709P12 RMis L-ki 1 _ SW-11702615 F—&2ZWr012 16:40:00 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 01 10 (Ed.1108) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS'COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY Number of Days Notice:90 (If no entry appears above,information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in PART SIX — CONDITIONS, D. Cancelation of the Workers' Compensation and Employers'Liability Insurance Policy or as amended by an applicable state cancellation endorsement,is increased to the number of days shown in the Schedule above. All other terms and conditions remain the same. This endorsement charges the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective April 1,2012 Policy No.CWG740901501 Endorsement No. Insured ATKINS US HOLDINGS INC. Insurance Company XL SPECIALTY INSURANCE COMPANY Countersigned by WC 99 01 10 Ed.1/08 V 2007 XL America,Inc. POLICY NUMBER: CGG740901601 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 PART SCHEDULE Name of Additional Insured Person(s) Or Organizations Location And Description of Completed Operations ANY PERSON OR ORGANIZATION WITH WHOM YOU VARIOUS AS REQUIRED PER WRITTEN CONTRACT. HAVE AGREED,THROUGH WRITTEN CONTRACT, AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE. 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". CG 20 37 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: CGG740901601 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations ANY PERSON OR ORGANIZATION WITH WHOM YOU VARIOUS AS REQUIRED PER WRITTEN HAVE AGREED,THROUGH WRITTEN CONTRACT, CONTRACT. AGREEMENT OR PERMIT,EXECUTED PRIOR TO THE LOSS,TO PROVIDE ADDITIONAL INSURED COVERAGE. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section II —Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for"bodily injury","property This insurance does not apply to"bodily injury'or damage" or "personal and advertising injury' .property damage"occurring after: caused,in whale or in part,by: 1. All work, including materials, parts or equip- 1. Your acts or omissions;or ment fumished in connection with such work, 2. The acts or omissions of those acting on your on the project(other than service,maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations has been completed;or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 0 ISO Properties,Inc.,2004 Page 1 of 1 ❑