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HomeMy WebLinkAboutCOI - Insituform Technologies, LLC - Expires 2022-07-01ACC>Roe CERTIFICATE OF LIABILITY INSURANCE �%.� 7/1/2022 DATE(MMIDOIYYYY) 6/23/2021 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 INSURERS), 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 Lockton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 CONTACT NAME: PHONE _7 Arc No Ext : AIC No : E-MAIL ADDRESS: INSURERISI 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 Comr)anV 22667 INSURER C: Indemnity Insurance Co of North America 43575 INSURER 0 : Starr Indemnity & Liability Company 38318 INSURER E: Indian Harbor Insurance Company 36940 INSURER F : COVERAGES 1NSTF.02 CFRTIFICATF NIIMRFR• R=%IlQl 1AI KII IMRCR- YYYYYYY 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP (MMIDD/YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY Y N CGD300084906 7/1/2021 7/1/2022 EACH OCCURRENCE $ 2,000.000 A CLAIMS -MADE a OCCUR BROAD FORM PD/CONTRAC UAL DAMAGE R A EES Ea oNaErrence S 1 ,000.000 X MED EXP (Any oneperson) 10,000 Indenendt Contractor XCU PERSONAL & ADV INJURY $ 2,000,000 _X_J GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JEST D LOC PRODUCTS - COMP/OP AGG s 4.000,000 OTHER: $ B AUTOMOBILE LIABILITY Y N W1S H2554867A 7/1/2021 7/1/2022 Ea accidenntSINGLE LIMIT $ 5,000,000 X BODILY INJURY (Per person) $XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX D UMBRELLA LIAB X OCCUR N N 1000095154211 7/1/2021 7/1/2022 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N N WLRC67822389 A/VIA) 7/1/2021 7/1/2022 PER OTH- X STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ NIA WLRC67822341 �ACOS) (EXCLUDING MNOPOLISTI 7/1/2021 ) 7/l/2022 E L. EACH ACCIDENTC $ l ,n0n0n0,n0n00 E.L. DISEASE - EA EMPLOYEE 1 ,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 E Contractors Pollution Liab Y N CPL742035808 7/1/2021 7/1/2022 $2,000,000 ea/ S2,000,000 agg S500,000 SIR E Professional Liab CE0742002409 7/1 /2021 7/1/2022 *See Below* DESCRIPTION OF OPERATIONS I LOCATIONS / 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) S5,000,000 Per Claim/Aggregate, $500,000 SIR. PROJECT NO, 17-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 WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED'S OPERATIONS, AND ARE ADDITIONAL INSUREDS UNDER INSTALLATION FLOATER AS REQUIRED BY WRITTEN CONTRACT. CaK 11 mt;AT E HULDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 15284929 AUTHORIZED REPRESENTATIVE CITY OF GILROY 7351 ROSANNA STREET GILROY CA 95020 �_06 ;-Ar ACORD 25 (2016103) ©1988- CORD CO ORA N. All rights reserved The ACORD name and logo are registered marks of ACORD Attachment Code : D592023 Master ID: 1425534, Certificate ID: 15284929 CITY OF GILROY 7351 ROSANNA STREET G I LROY CA 95020 IMPORTANT NOTICE To whom it may concern: 1 IR In our continued effort to provide timely certificate delivery, Lockton Companies is transitioning to paperless delivery of Certificates of Insurance going forward. To ensure future renewals of this certificate, we need your email address. Please contact us via one of the methods below, referencing Certificate ID 15284929 Email: stl-edelivery@tockton.com Phone: (866) 728-5657 (toll -free) If we do not receive your email address via one of the above methods prior to the client's next renewal, we will assume you no longer need the certificate. If you received this certificate through an internet link where the current certificate is viewable, we have your email and no further action is needed. The above inbox is for collecting email addresses for renewal electronic certificate delivery ONLY. You will not receive a response from this inbox. Thank you for your cooperation. Lockton Companies Lockton Companies Three CityPlace Dr. Suite 900 / St. I-ouis, N40 63141-7088 I4-432-0500 / lockton.com Attachment Code: D544456 Certificate ID : 15284929 ENDORSEMENT # This endorsement, effective 12:01 a.m., 7/1/2021, forms a part of Policy No. CGD300084906 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 Number of Days Name of Person(s) or Entity(ies) Mailing Address: Advanced Notice of Cancellation: AS PER SCHEDULE ON FILE WITH 30 THE COMPANY. All other terms and conditions of the Policy remain unchanged. IXI 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 Policy Number Policy Period Effective Date of Endorsement ISA W I S 7/1 /2021 To 7/1 /2022 H2554867A 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 subseauent 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 Named Insured AEGION CORPORATION 17988 EDISON AVENUE CHESTERFIELD MO 63005 PolicyPeriod 7/1 /2021 TO 7/1 /2022 Workers' Compensation and Employers' Liability Policy EndorsementNumber Policy Number Symbol: WLR Number: WLRC67822341 (AOS) Effective Date of Endorsement 7/1 /2021 IssuedBy (Name of InsuranceCompany) Indemnitv Insurance Co of North America Insert the Policv number. The remainder of the information is to be completed only when this endorsement is issued subseauent to the preparation of the policv. 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 Attachme 544757 Certificate ID : 15284929 Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. Notice of Cancellation or Nonrenewal to Designated Additional Insured Policy Number: 1000095154211 Named Insured: Aegion Corporation Effective Date: 7/1 /2021 at 12:01 A.M. This endorsement modifies insurance provided under the following: EXCESS LIABILITY POLICY FORM ADDITIONAL ENTITY RECEIVING NOTICE OF CANCELLATION OR NONRENEWAL NAME: Where Required By Written Contract ADDRESS: Where Required By Written Contract CANCELLATION: WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: 30 Number of Days Notice: 30 The following is added to the Cancellation Condition, When We Do Not Renew Condition or as amended by an applicable state cancellation/nonrenewal endorsement: If we cancel or do not renew the Named Insured's policy for any statutorily permitted reason, other than nonpayment of premium, we will mail written notice of such cancellation or nonrenewal to the additional person or organization designated in the Schedule above. The Number of Days Notice indicated in the Schedule above is the minimum number of days we will mail notice to the person or organization designated above before the effective date of such cancellation or nonrenewal All other terms and conditions of this Policy remain unchanged. Signed for the Company as of the Effective Date above: Steve Blakey, President 04- iF. --11 Nehemiah E. Ginsburg, General &unsel XS 106 (04/11) Page 1 of 1 Copyright ©C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code : D546224 Certificate ID : 15284929 ENDORSEMENT This endorsement, effective 12:01 a.m., July 1, 2018, forms a part of Policy No. CE0742002406 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: PACE: 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 Number of Days Name of Person(s) or Entity(ies) Mailing Address: 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 4 2014 X.L. America, Inc. Page 1 of 1 All Rights Reserved. May not be copied without permission.