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HomeMy WebLinkAboutCOI - Insituform Technologies, LLC - Expires 2021-07-01ACORD' CERTIFICATE OF LIABILITY INSURANCE �....--'" 7/1/2021 DATE(MMIDDIYYYY) 6/23/2020 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 A Lockton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 CONTACT NAME: PHO(A/C, No, EXt): (NC, No): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A : XL Insurance America, Inc. 24554 INSURED Insituform Technologies, LLC 1425534 17988 Edison Avenue Chesterfield MO 63005 INSURER B : ACE American Insurance Company 22667 INSURER C : Indemnity Insurance Co of North America 43575 _INSURER Ds_Starr Indemnity & Liability Company 38318 INSURER_E_Indian Harbor Insurance Company 36940 INSURER F : COVERAGES INSTE02 CERTIFICATE NUMBER: 15284929 REVISION NUMBER: XXXXXXX 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 THR 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'I LTR TYPE OF INSURANCE 1 ADM INSD SUN WVD POLICY NUMBER POLICY EFF (MMIDDJYYYYF POLICY EXP (MMIDDIYYYYI LIMITS A A X COMMERCIAL GENERAL LIABILITY OCCUR y N CGD300084905 I BROAD FORM D/CONTRACTUAL 7/1/2020 7/1/2021 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE x PRMMGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 X Indcpcndt Contractor MED EXP (Any one person) $ 10,000 X 2{CU PERSONAL & ADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 $ 4,000,000 POLICY X Fitlei X LOC PRODUCTS - COMP/OP AGG OTHER: $ B AUTOMOBILE LIABILITY ANY AUTO AUTOS ONLY AUTOS ONLY SCHEDULED AUTO ONLYY Y N ISA 1125302540 7/1/2020 7/ 1 /202 I (Ea acccldeDtSINGLE LIMIT $ 5,000,000 X BODILY INJURY (Per person) S XXXXXXX BODILY INJURY (Per accident $ XXXXXXX _ _ nDAMAGE (Per PROPERTY S XXXXXXX $ XXXXXXX D 1 UMBRELLA LIAB EXCESS LIAB f X OCCUR CLAIMS -MADE N N 1000095154201 7/1/2020 7/1/2021 EACH OCCURRENCE $ 10,000,000 X '1- AGGREGATE S 10,000,000 DED RETENTION $ $ XXXXXXX B C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (MandatoryyIn NH) DESCRIPTION OF OPERATIONS below Y / N N I A N WLRC67457262 (CA/MA) WLRC67457225 (ADS) (EXCLUDING MONOPOLISTIC 7/1/2020 7/1/2020 ) 7/1/2021 7/1/2021 PER OTH- X STATUTE ER N E L EACH ACCIDENT $ 1,000,000 E I. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT S 1,000,000 E E Contractors Pollution Liab Professional Liab y N CP1,742035807 CE0742002408 7/1/2020 7/1/2020 7/1/2021 7/1/2021 S2,000,000 ea/ $2,000,000 agg $500,000 SIR *See Below* DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) * Includes Pollution Coverage for conditions arising from waste or materials transported by or on behalf of Named Insured via automobile during the course of performing covered operations. Professional Liability: (Claims -Made, Retro Date 7/1/2016) $5,000,000 Per Claim, $500,000 SIR. PROJECT NO. I7-PW-235, SEWER REHABILITATION IN FIRST STREET. CITY OF GILROY, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE ADDITIONAL INSUREDS UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY ON A PRIMARY AND NON-CONTRIBUTORY BASIS WHERE APPLICABLE BY WRTI"TEN CONTRACT, BUT ONLY WITF-I RESPECT TO LIABILITY ARISING OUT OF Ti IF NAMED INSURED'S OPERATIONS, AND ARE ADDITIONAL INSUREDS UNDER INSTALLATION FLOATER AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION See Attachments 15284929 CITY OF GILROY 7351 ROSANNA STREET GILROY CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988- CORD CO ORA N. All rights reserved The ACORD name and logo are registered marks of ACORD 'Attachment Code : D544456 Certificate ID : 15284929 ENDORSEMENT # This endorsement, effective 12:01 a.m., 7/1/2020, forms a part of Policy No. CGD300084905 issued to AEGION CORPORATION By XL Insurance America, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification Name of Person(s) or Entity(ies) Mailing Address: Number of Days Advanced Notice of Cancellation: AS PER SCHEDULE ON FILE WITH THE COMPANY. 30 All other terms and conditions of the Policy remain unchanged. 'XI 405 0910 © 2010 X.L. America, Inc. All Rights Reserved. Attachment Code : D543763 Certificate ID : 15284929 NOTICE TO OTHERS ENDORSEMENT SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE Named Insured Aegion Corporation Policy Symbol ISA Policy Number ISA H25302540 Policy Period 7/1/2020To 7/1/2021 Effective Date of Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company nsert 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. A. If we cancel this Policy prior to its expiration dale by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will In turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply In the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. Authorized Representative ALL-32686 (01/11) Page 1 of 1 'Attachment Code : D544740 Certificate ID : 15284929 Workers' Compensation and Employers' Liability Policy Named Insured AEGION CORPORATION 17988 EDISON AVENUE CHESTERFIELD MO 63005 EndorsementNumber Policy Number Symbol: WLR Number: WLRC67457225 (AOS) PolicyPeriod 7/1/2020 TO 7/1/2021 Effective Date of Endorsement 7/1/2020 IssuedBy (Name of InsuranceCompany) Indemnity Insurance Co of North America 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. NOTICE TO OTHERS ENDORSEMENT — SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. This endorsement is not applicable in the states of AZ, FL, ID, ME, NC, NJ, NM, TX and WI. Authorized Representative WC 99 03 69 (01/11) Page 1 of 1 Attachment Code : D544757 Certificate ID : 15284929 Starr Indemnity & liability Company Dallas, TX 1-866-519-2522 Earlier Notice of Cancellation Provided by US Policy Number: 1000095154201 Effective Date: 7/1/2020 at 12:01 A.M. Named Insured: Aegion Corporation SCHEDULE Number Of Days' Notice 90 For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in Paragraph 2. of either the Cancellation Condition 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 of this Policy remain unchanged. Signed for the company as of the Effective Date above: Charles H. Dangelo, President Nehemiah E. Ginsburg, GeneralCounsel XS 147 (10108) Page 1 of 1 Copyright (0 C. V. Starr 8 Company and Starr Indemnity 8 Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc,. used with Its permission. .Attachrgent Code : D546224 Certificate ID : 15284929 ENDORSEMENT This endorsement, effective 12:01 a.m., July 1, 2018, forms a part of Policy No. CEO742002406 issued to AEGION CORPORATION by Indian Harbor Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MANUSCRIPT ENDORSEMENT - CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT This endorsement modifies insurance provided under the following: PA/CE: Professional Activities/Complete Execution PROFESSIONAL LIABILITY FOR CONSTRUCTION CONTRACTORS AND CONSTRUCTION SUPPORT SERVICES PROVIDERS In consideration of the premium charged, the Named Insured and the Company agree to the following Policy change(s): In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown Name of Person(s) or Entity(ies) Mailing Address: Number of Days Advanced Notice of Cancellation: Per Schedule on File with the Company 60 60 All other terms, conditions and exclusions of this Policy remain unchanged. KPD 404 1214 © 2014 X.L. America, Inc. Page 1 of 1 All Rights Reserved. May not be copied without permission.