CC - Agendas - City Council - REGULAR - 8/14/2018

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1 UIIit3L-1 ,4�oRO CERTIFICATE OF LIABILITY INSURANCE OP ID: DB DATE(MMIDDIYYYV) 06/13/2018 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(les) 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 602-264-5533 Stuckey Ins & Assoc Agencies 2850 E Camelback Rd, Suite 325 Phoenix, AZ 85016 Scott Schmidt CONTACT Teresa Alvarado PHONE 602-264-5533 FAX 602-279-9336 (AIC, No, Ext): (A/C, No): ADMRIESS: teresa.alvarado@stuckeyinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Berkley Insurance Company 32603 INSURED Dibble & Associates Consulting 7878 N. 16th St., Ste. 300 Phoenix, AZ 85020 INSURERS: INSURER C : INSURER 0 : INSURER E : INSURER F : COVERAGES • • 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 I D D BURR WVD POLICY NUMBER I POLICY D YI MICA YI LIMITS COMMERCIAL GENERAL LIABILITY OCCUR EACH OCCURRENCE $ i CLAIMS -MADE DAMAGE PREMSET REoccu once) $ GEN'L MED FRCP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY l— , 'ECOT [LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE — — LIABILITY ANY AUTO OWNED AUT�OpS ONLY ONLY ' SCHEDULED AUTOS yy Ep _ AUUTOS ONNLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Perr accidentDAMAGE PAUTOS $ $ — UMBRELLA LIAB EXCESS LAB OCCUR CLAIMS -MADE '' EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A '', '.., STATUTE ERH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liab AEC-9020878-00 02/28/2018', 02/28/2019 Per Claim Aggregate 5,000,000 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached I/ more space Is required) Professional Liability - Claims Made - Retro Date 10/31/1962 Re: Prescott Municipal Airport Design and Engineering Services RSOQ#18AP002 CERTIFICATE HOLDER CANCELLATION PO '6d 49)PPed CZPRE-1 City of Prescott Prescott Municipal Airport Director 6546 Crystal Lane Presott, AZ 86301 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 :ORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights resery The ACORD name and logo are registered marks of ACORD Attachment: SOQ for Airport Design & Engineering Services (2126 : Dibble Engineering Contract e0 11