2011-362 Planning - Terracon Consultants, Inc. for Buckhorn Efland Phase 2 Sanitary Sewer Construction Materials Testing

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,q►� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) [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. the MPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to forms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the ertificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies,LLC-I Kansas City C TACT 444 W.47th Street,Suite 900 N e PHONE F Kansas City MO 64112-1906 AIC No (816)960-9000 ADD INSURERS AFFORDING COVERAGE NAiC/ INSURERA:(' S' E NS.CO.** 1 TERRACON CONSULTANTS,INC. INSURER B:** 13312$129 91 18001 W. 106TH STREET,SUITE 300 OLAT14E KS 66061 INSURER C:Travelers Property Casualty Co of America 25674 INSURER D:The Travelers Indenmity ConivaLay 25658 INSURER E:Lexington Insurance Company 19437 COVERAGES TERCO01 PC CERTIFICATE NUMBER: 11281774 RERF, REVISION NUMBER: XXX}{XXX 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 At3D SUER LTR TYPE OF INSURANCE I R POLICY NUMBER PwDDYyr MOMILDICY E:� LIMITS A GENERAL LtABRITY N N PROP3779274 1/1/2011 1/1/2012 MMERCIAL GENE ILITY PREMISES(t RENTED o nee S 300 QQQ CLAIMS-MADE OCCUR X CONTR'L LIABILITY MED EXP(Any one rson s PERSONAL S ADV INJURY $ 1,000 a 000 GENERAL AGGREGATE $GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-OOMP/OP AGG S POLICY nX P�O" LOC S C AUTOMOBILE LIABILITY N N TC2J-CAP-131J3858 1/1/2011 1/12FO12 TJBAP]3)J3895 1/1/2011 1/1/2012 (Eaacctdent) S �_ JX AN Y AUTO BODILYINJURY(Perperson) S { {} {ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident S { HIRED AUTOS X NONOSWNED PRO('ERTY DAMAGE s XXXXXXX A L4 UMBRELLA LIAB RE �{ OCCUR N N PROU1920977 I/I/2011 1/1/2012 EACH OCCURNCE sXXXXXXX S A X EXCESS Luis CLAIMS-MADE (EXCLUDES PROF.LIAB.) 5.000.000 AGGREGATE S 0 DEO I I RETENTIONS WORKERSCOMPENSATION S U AND EMPLOYERS' YIN YIN N TRJ-U3-l31J3846(AZ OR,NV1) 1/1/2011 1/1/2012 X TORV LIMIT ER ANY PROPRI£foR/PARTNERlEXECUTNE TC2KUB131J3742(AdS) 111/2011 1/)/2012 OFFICE,UEMS REXCLUDED7 NIA EL.EACH ACCIDENT $ 1,000.0 0. (Mandatory f yes.d H) E.L.DISEASE-EA EMPLOYE S 1 000 000 If yyeess desedba under DESCRI-ION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 E PROFESSIONAL N N 026030216 1/1/2011 1/1/2012 51,000,000 EACH CLAIM& LIABILITY S 1,000,000 ANNUAL AGGREGATE DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) FOR INFORMATIONAL PURPOSES ONLY.EXCESS LIABILITY SITS ON TOP OF GENERAL AND AUTO LIABILITY. 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, 11281774 AUTHORIZED REPRESENTATIVE SPECIMEN ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 988-2010 AJOWCORPORATION.All rights reserved