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Wood Environment & Infrastructure Solutions - Insurance Certificate (2019)
A� °® CERTIFICATE OF LIABILITY INSURANCE DATE(MMI 09/04/22018 018 Y) 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 AOn Risk Services SOUthW25t, Inc. Houston TX office CONTACT NAME: PHONE (866) 283 -7122 FAX (800) 363 -0105 (A/C. No. Ext): A/C. No.: 5555 San Felipe Suite 1500 E -MAIL ADDRESS: Houston TX 77056 USA HDOG INSURER(S) AFFORDING COVERAGE NAIClF INSURED INSURERA: ACE American insurance Company 22667 wood Group USA, Inc. fka AmeC Foster wheeler 17325 Park Row INSURER B: Agri General Insurance Company 42757 INSURER C: ACE Fire Underwriters Insurance Co. 20702 Houston TX 77084 USA INSURER D: AIG Specialty Insurance Company 26883 $2,000,000 INSURER E: Lloyd's syndicate No. 2003 AA1128003 INSURER F: COVERAGES CERTIFICATE NUMBER: 570072910033 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. Limits shown are as requested IN SR LTR TYPE OF INSURANCE ADD INSD UBR WVO POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG EACH OCCURRENCE $2,000,000 CLAIMS -MADE M OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $2,000,000 MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY EPRO ❑ LOC JECT PRODUCTS - COMP /OPAGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY ISA H25150132 05/01/2018 01/31/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANYAUTO OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED PROPERTY DAMAGE ONLY AUTOS ONLY Per accident A X UMBRELLALIAB X OCCUR XOOG24876238009 05/01/2018 01/31/2019 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $1,000,000 DED I X RETENTION $10,000 A WORKERS COMPENSATION AND WLRC64625196 05/01/2018 01/31/2019 X PER STATUTE OTH- ER EMPLOYERS' LIABILITY YIN Work Comp- AOS E.L. EACH ACCIDENT $1,000,000 B ANY PROPRIETOR / PARTNER / EXECUTIVE N/A WLRC64625202 05/01/2018 01/31/2019 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) Work Comp- TN E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $1,000,000 E Archit &Eng Prof PSDEF1800726 0 18 06/30/2019 Any One Claim $2,000,000 Professional Liability �0710112 Aggregate Limit $2,000,000 SIR applies per policy ter s & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED ADDENDUM FOR ADDITIONAL NAMED INSURED AMEC COMPANIES. Re: Project Description: City of Gilroy NPDES compliance services for fiscal year 2018 - 2019, Estimated Contract Price $29,200 City of Gilroy, its agents, officers, officials, employees, and volunteers are included as Additional insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. Should General Liability, Automobile Liability, Professional Liability and workers' compensation be before the date policies cancelled expiration thereof, the policy provisions will govern how notice of cancellation may be delivered to certificate holders in accordance with the policy provisions. CERTIFICATE HOLDER CANCELLATION U d m d a 0 x M 0 0 rn rl- 0 0 O Z d is V 1:.' N U �C ti ti- 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 Gilroy AUTHORIZED REPRESENTATIVE 7351 Rosanna Street Gilroy CA 95020 USA z or y�J� ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD }AGENCY CUSTOMER ID: 570000021966 ! LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Southwest, Inc. NAMED INSURED wood Group USA, Inc. POLICY NUMBER see Certificate Number: 570072910033 CARRIER See certificate Number: 570072910033 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER SUBR wVD INSURER POLICY EFFECTIVE DATE (MM /DD/YYYY) INSURER LIMITS INSURER WORKERS COMPENSATION ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR wVD POLICY NUMBER POLICY EFFECTIVE DATE (MM /DD/YYYY) POLICY EXPIRATION DATE (IVIMfDD/YYYY) LIMITS WORKERS COMPENSATION C N/A RWCC64785825 Work Comp- wI 05/01/2018 01/31/2019 AQURD 1131 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I AGENCY CUSTOMER ID: 570000021966 LOC #: ,4� R ADDITIONAL REMARKS SCHEDULE Paoe _ of _ AGENCY Aon Risk services southwest, Inc. NAMED INSURED wood Group USA, Inc. POLICY NUMBER see certificate Number: 570072910033 CARRIER See Certificate Number: 570072910033 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Named insured & FKA Named Insureds: AmeC Foster wheeler AmeC Foster Wheeler E &I, Inc. AGRA Pipeline Professionals, Inc. AMEC AES AMEC Civil, LLC AMEC Construction Management, Inc. AMEC E &I, Inc. AmeC Foster Wheeler AES Inc. (formerly AMEC AES, Inc.) AMEC E &E, P.C. AMEC Earth and Environmental, Inc. AMEC Engineering and Consulting of Michigan, Inc. AMEC Environment & Infrastructure, Inc. AmeC Foster Wheeler USA Corporation AmeC Foster wheeler Programs Inc. AmeC Foster Wheeler Constructors, Inc. AmeC Foster wheeler Energia, S.L.U. AmeC Foster wheeler E &C Services, Inc. (formerly AMEC E7C Services, Inc.) AmeC Foster Wheeler E &I, Inc. AmeC Foster wheeler industrial Power Company, Inc. AMEC Massachusetts, Inc. AmeC Foster Wheeler Martinez Inc. AmeC Foster Wheeler North America Corp AmeC Foster wheeler ventures, Inc. (formerly National ventures, Inc.) AMEC NNC USA, Inc. AMEC Nuclear USA Inc. AMEC Offshore, Inc. AmeC Foster Wheeler Oil and Gas, Inc. (formerly AMEC Oil & Gas, Inc.) AMEC Paragon Inc. AMEC PLC AMEC Technologies, Inc. AmeC Foster Wheeler USA Corporation AMEC USA Holding, Inc. Foster wheeler Intercontinental Corporation DEST Associates, Inc. AmeC Foster Wheeler Kamtech, Inc. (formerly AMEC Kamtech, Inc.) MACTEC Engineering and Consulting, P.C. North American Shared Services (NASS) QED International LLC Rider Hunt International USA, Inc. Terra Nova Technologies, Inc. (TNT) Oil & Gas US, Central & South America wood Group USA, Inc. wood Group Alaska, Inc. Wood Group PSN, Inc. Altablue, Inc. Cape Software, Inc. BMA Solutions, Inc. Global Performance, LLC john Wood Group PLC RWG (Repair & Overhauls) USA, Inc. SgurrEnergy, Inc. Ingenious, Inc. Mustang Process and Industrial Mustang International, LP Mitchell's oil Field Services, Inc. C.E.C. Controls Company, Inc. wood Environment & Infrastructure Solutions Inc. Wood E &IS, Inc. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD j AGENCY CUSTOMER ID: 570000021966 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Southwest, Inc. NAMED INSURED Wood Group USA, Inc. POLICY NUMBER see Certificate Number: 570072910033 CARRIER see certificate Number: 570072910033 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Named Insured & FKA Formerly Known As: AMEC Foster wheeler Environment & Infrastructure, Inc.(formerly AMEC Environmernt & Infrastructure, Inc.) wood Group Mustang, Inc. wood Group Kenny, Inc. wood Group Management Services, Inc. ODL, Inc. Wood Group Production and Consulting Services, Inc. wood Group PSN Commissioning Services, Inc. wood Group PSN Lease Maintenance & Construction, LLC DSI Deepwater Specialists, Inc. Caliber Services, LP Infinity construction services, LP Infinity Maintenance Services, LP United Electrical & Instrumentation, Ltd. Brazos M &E, Ltd. Elkhorn Holdings, Inc. Elkhorn construction, Inc. Elkhorn Pipeline Services HOAD Prosafe Dynamic Services ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CHUBB0' LEAD SHEET FOR: AON RISK SERVICES SOUTHWEST INC RUN DATE: 09/06/2018 POLICY NUMBER: HDO 627874265 ID: Z02FERR1 RUN BY: ACEINA\RDFERR PAGES OF THIS COPY: 0008 INSURED'S NAME John Wood Group PLC 2 POLICY NUMBER: HDO 627874265 CHUBFR' Policyholder Notice Commercial Lines Deregulation New York NOTICE: THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. HOWEVER, THE FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS. CLASS CODE 2 -14057 ALL- 23445b (07/13) Page 1 of 1 GENEhALENDORSEMENT Named Insured Endorsement Number John Wood Group PLC 224 Policy Symbol Policy Number Policy Period Effective Date of Endorsement H DO 627874265 I 01/31/2018 to 01/31/2019 09/04/2018 Issued By (Name of Insurance Company) ACE American Insurance Company insert the policy number. I he 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: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is agreed effective 09/04/2018 that the following endorsement is added to the policy: Endt. 225, CG2026 0413 Additional Insured - Designated Person Or Organization Authorized Representative CC -3R19 (8/97) Page 1 of 1 POLICY NUMBER: HDO G27874265 1 1 Endorsement Number: 225 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): City of Gilroy, its agents, officers, officials, employees and volunteers. 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 is added to Section 111 — 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 applicable Limits of Declarations. shall not increase the Insurance shown in the CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1