Holder Identifier : 7 570093508939
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
06/08/2022
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be en dorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A stat ement 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.
PRODUCER
Aon Risk Services Northeast, Inc.
Aon Risk Services Northeast, Inc.
NY NY Office
One Liberty Plaza
165 Broadway, Suite 3201
PHONE
(A/C. No. Ext):
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
866-283-7122
INSURED 19682Hartford Fire Insurance Co.INSURER A:
27120Trumbull Insurance CompanyINSURER B:
35300Allianz Global Risks US Insurance Co.INSURER C:
INSURER D:
INSURER E:
INSURER F:
FAX
(A/C. No.): (800) 363-0105
CONTACT
NAME:
Bureau Veritas Technical Assessments LLC
10461 Mill Run Circle, Suite 1100
Owings Mills MD 21117 USA
COVERAGES CERTIFICATE NUMBER: 570093508939 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO D 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.
Limits shown are as requested
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
(MM/DD/YYYY)
SUBR
WVD
INSR
LTR
ADDL
INSD POLICY NUMBER TYPE OF INSURANCE LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
POLICY LOC
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
X
X
XX
GEN'L AGGREGATE LIMIT APPLIES PER:
$2,000,000
$1,000,000
$10,000
$2,000,000
$2,000,000
$2,000,000
C 01/01/2022 01/01/2023USL00159322
PRO-
JECT
OTHER:
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
SCHEDULED
AUTOS
HIRED AUTOS
ONLY
NON-OWNED
AUTOS ONLY
BODILY INJURY ( Per person)
PROPERTY DAMAGE
(Per accident)
X
BODILY INJURY (Per accident)
$2,000,000A 01/01/2022 01/01/2023
AOS
10 AB S41203A 01/01/2022 01/01/2023
HI
COMBINED SINGLE LIMIT
(Ea accident)
10 AB S41202
EXCESS LIAB
X OCCUR
CLAIMS-MADE AGGREGATE
EACH OCCURRENCE
DED
$1,000,000
$1,000,000
$10,000
01/01/2022UMBRELLA LIABC 01/01/2023USL00163322
RETENTIONX
X
E.L. DISEASE-EA EMPLOYEE
E.L. DISEASE-POLICY LIMIT
E.L. EACH ACCIDENT $1,000,000
X OTH
-
PER STATUTEB 01/01/2022 01/01/2023
See State Policy Addendum
$1,000,000
Y / N
(Mandatory in NH)
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED? N / AN
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
If yes, describe under
DESCRIPTION OF OPERATIONS below
$1,000,000
10WNS41200
Each ClaimUSF00248022 01/01/2022 01/01/2023
Claims Made $2,000,000Aggregate
Archit&Eng ProfC
SIR applies per policy terms & conditions
$2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of insurance. The Architects & Engineers policy includes coverage for Professional Liability and Contractors Pollution Liability. Certificate Holder is included as Additional Insured in accordance with the policy provisions of the Business Auto Coverage & General Liability Coverage policy.
CANCELLATIONCERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVECity of Alameda Public Works Department Alameda Point, Building 1
950 West Mall Square, Room 110
Alameda CA 94501-7558 USA
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
Workers Compensation/Employers Liability
AGENCY CUSTOMER ID:
ADDITIONAL REMARKS SCHEDULE
LOC #:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance EFFECTIVE DATE:
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSUREDAGENCY
See Certificate Number:
See Certificate Number:
Aon Risk Services Northeast, Inc.
570000048582
570093508939
570093508939
Page _ of _
Bureau Veritas Technical Assessments LLC
10WNS41200 01/01/22-01/01/23 Trumbull Insurance AR,DC,IN,LA,NE,RI,UT 10WNS41200 01/01/22-01/01/23 Twin City Fire Insurance Company FL,ND,OH,WA,WY 10WNS41200 01/01/22-01/01/23 Hartford Insurance Company of the Midwest AK,ID 10WNS41200 01/01/22-01/01/23 Hartford Casualty Insurance Company MO,WV 10WNS41200 01/01/22-01/01/23 Nutmeg Insurance Company CT,IL 10WNS41200 01/01/22-01/01/23 Hartford Fire Insurance Company NH,OR,PA 10WNS41200 01/01/22-01/01/23 Hartford Accident and Indemnity Company AL,GA,KY,MI,MT,NY,TN,VT 10WNS41200 01/01/22-01/01/23 Property & Casualty Ins Co of Hartford CA,CO,DE,ME, MN,MS,SC 10WNS41200 01/01/22-01/01/23 Hartford Insurance Company of Illinois TX 10WNS41200 01/01/22-01/01/23 Hartford Insurance Company of the Southeast KS,MD 10WNS41200 01/01/22-01/01/23 Hartford Underwriters Insurance Company AZ,HI,NC,NJ,SD,VA 10WNS41200 01/01/22-01/01/23 Sentinel Insurance Company, Limited IA,NM,NV,OK 10WBRS41201 01/01/22-01/01/23 Twin City Fire Insurance Company WI 10WBRS41201 01/01/22-01/01/23 Hartford Underwriters Insurance Company MA 10WBRS41201 01/01/22-01/01/23 Hartford Fire Insurance Company PR ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
BUREAU VERITAS HOLDINGS, INC.
01/01/2022
HARTFORD FIRE INSURANCE COMPANY
10 AB S41202
10 AB S41202 01/01/2022
01/01/2023
BUREAU VERITAS HOLDINGS, INC.
1601 SAWGRASS CORPORATE PARKWAY, SUITE 400
FORT LAUDERDALE, FL 33323
ANY LESSORS AS REQUIRED BY WRITTEN CONTRACT
ALL LEASED AUTOS LEASED FROM A LESSOR AS REQUIRED ABOVE
ALL LEASED AUTOS LEASED FROM A LESSOR AS REQUIRED ABOVE
2,000,000
1,000
1,000
NOT COVERED
Policy Number: USL00159322
Effective Date: January 01, 2022
COMMERCIAL GENERAL LIABILITY
CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2
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) Location(s) Of Covered Operations
Any owner, lessee or contractor for whom
you are performing operations when you
and such owner, lessee or contractor have
agreed in writing in a contract or agreement
that such owner, lessee or contractor
should be added as an additional insured
on your policy.
Locations that are listed in the written
contracts or agreements stated on the left
side of this SCHEDULE.
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
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.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
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
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.
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III – Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
AGRL-IL 8002 (11-12) Page 1 of 1
Policy Number: USL00159322
Effective Date: January 01, 2022
THIS ENDORSMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADVICE OF CANCELLATION TO ENTITIES OTHER THAN AN INSURED
LIMITED TO EMAIL NOTIFICATION
This policy is amended as follows:
If we initiate cancellation of this policy for any reason other than non payment of premium, and A. The effective date of cancellation is prior to this policy’s expiration date; and B. The “First Named Insured” is under an existing contractual obligation to notify an entity to whom a certificate of insurance has been issued (hereinafter, the Certificate Holder) when this policy is canceled; and C. The “First Named Insured” has provided us, either directly or through the “First Named Insured’s” broker of record the email address of the contact of each such Certificate Holder; and D. We received this information after the “First Named Insured” receives notice of cancellation of this policy and prior to the policy’s cancellation date in an electronic spreadsheet format that is acceptable to us; We will provide “Advice of Cancellation” via e-mail to such Certificate Holders.
Proof of emailing the “Advice of Cancellation”, using the inf ormation provided by the “First Named Insured”, will serve as proof that we have fully satisfied our obligations under this endo rsement. The “Advice of Cancellation” shall be emailed to each such Certificate Holder as soon as possible upon re ceipt of the information from the “First Named Insured”, however we are under no contractual obligation to email the “Advice of Cancellation” prior to the policy’s cancellation date.
This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy of the effective date of such cancellation. Nor shall this endorsement invest any rights to any entity that is not an insured under the terms of this policy.
The following Definitions apply to this endorsement:
A. “First Named Insured” means the Named Insured shown on the Declarations Page of this policy.
B. “Advice of Cancellation” means an email that provides the following information:
1. The Named Insured as shown on the Declarations Page of this policy;
2. The policy number of the policy being cancelled: and
3. The effective date and time of the cancellation.
All other terms and conditions remain unchanged.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
UTAH WAIVER OF SUBROGATION ENDORSEMENT
Policy Number: Endorsement Number:
Effective Date: Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address:
This endorsement applies only to the insurance
provided by the policy because Utah is shown in Item
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Our
waiver of rights does not release your employees’
rights against third parties and does not release our
authority as trustee of claims against third parties.
3.A. of the Information Page.
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.)
Schedule
Countersigned by
Authorized Representative
Form WC 43 03 05 Printed in U.S.A.
10 WN S41200 72
01/01/2022
BUREAU VERITAS HOLDINGS, INC.
1601 SAWGRASS CORPORATE PKWAY
SUITE 400
FORT LAUDERDALE, FL 33323
ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US.