HomeMy WebLinkAboutInsurance Certificate: Peck Smiley Ettlin Architects sw.l
A`OR°® CERTIFICATE OF LIABILITY INSURANCE 03-20.20112
THIS CERTIFICATEIS 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 CERTIFICATEOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($).AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policyfies)must be endorsed. If SUBROGATIONIS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statementon this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
FULLERTON & COMPANY INC/PHS PHONE
709437 P: (866) 467-8730 F : (877) 905-0457 A/C No ExII: (866) 467-8730 ; IA/C,NOI: (877) 905-0457
PO BOX 33015 ADDRESS:
SAN ANTONIO TX 78265 CUSTOMERIDa:
INSURERISI AFFORDING COVERAGE NAIC p
INSURED INSURERA- Hartford Casualty Ins CO
PECK, SMILEY, ETTLIN ARCHITECTS INC. INSURER B:
NED PECK, STEVE SMILLEY, & HANS ETTLIN
4412 S .W. CORBETT AVE. INSURER C
PORTLAND OR 97239 INSURER D
INSURER E
INSURER F .
COVERAGES CERTIFICATE NUMBER: 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.
LTA TYPE OF INSURANCE INSR WVD POLICY NUMBER 1
IMMIDD/YYYYI IMMIDDIYYYYI ! LIMBS
GENERAL LIABILITY I EACH OCCURRENCE 1 $ 2 , 000, 000
COMMERCIAL GENERAL LIABILITY I f4A1GDOGE-P6AEI I
PREMISES IEe occurrence) 1 s 300, 000
A CLAIMS MADE X OCCUR I MED EXP(An,one person/ 5 10, 000
X General Liab X 52 SBA UL7992 104/01/20121 04/01/2013! PERSONAL B ADV INJURY S 2, 000, 000
iGENERAL AGGREGATE s 4 , 000, 000
'L AGGREIIGATIEI LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG 1 s 4 , 000, 000
POLICY a PRCT X LOC 5
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANYAUTO IEnnccidew) s— 2 , 000, 000
5
BODILY INJURY We,Person/
ALL OWNED AUTOS I BODILY INJURY IPer eccid,mOI $
SCHEDULED AUTOS
A X HIRED AUTOS 152 SBA UL7992 04/01/20121 04/01/20131 PROPERTY DAMAGE $
I IPer xcideml
X NON-OWNED AUTOS 1 $
UMBRELLA UAB I OCCUR
EACH OCCURRENCE 5
(EXCESS LIAB I CLAIMS MADE AGGREGATE s
DEDUCTIBLE S
RETENTION 9 s
WORKERS COMPENSATION j
'AND fMP LONERS'LIABILITY WC STATU- ! �OTH
Y'NI -_ E. l ,.-
ANY PRO FRI ETORMARTNER/EXECUTIVE-
OFFICER/MEMBEREXCLUDED] u!NIA IE.L.EACH ACCIDENT S
(Mendem y In NH)
If yes,desdibe under E.L.DISEASE EA EMPLOYE ' $
DESCRIPTION OF OPERATIONS below E .DISEASE POLICY LIMIT I 5
VV
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(AUxh ACORD 101.Adcitlorwl Re N adWe.II mou specs is rxluratll
Those usual to the Insured' s Operati APR - 2 2012
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
City of Ashland, It ' s Officers BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
Employees, and Agents . DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,
20 East Main Street AUTHORIZE PRESENTATIVE
Ashland, OR 97520 IA-
. e 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD