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HomeMy WebLinkAboutInsurance Certificate: Marquess & Associates (2) AC")?"* osllazol CERTIFICATE OF LIABILITY INSURANCE DATE 4/201z rr 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 be endorsed. N 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 Phone: (360)598-3700 Fax: (360)598-3703 CONTACT Aime Carroll MICHAEL J.HALL&COMPANY PHONE FA% HALL&COMPANY Arc Ne Ex1 (360)598-3700 ,��: (360)596.3703 19660 10TH AVENUE N.E. DDRL ADDRESS' acamoll @hallandcompany.com A POULSBO WA 98370 INSURERS) AFFORDING COVERAGE MAC INSURER : Travelers Casualty and Surety Co of America 31194 ° INSURED INSURER B The Travelers Indemnity Company of America 25666 Marquess&Associates Inc PO Box 490 INSURER C : The Travelers Indemnity Company 25658 Medford,OR 97501-0033 INSURER NSURER E NSURERF COVERAGES CERTIFICATE NUMBER: 159547 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. INSR TYPE OF INSURANCE ADD'L SUBR POLICY NUMBER POLICY EFF POLICY UP LIMITS R N M B GENERAL LIABILITY 6806146N63A 05/29112 05129113 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 300,000 PREMISES Ea o=mn `1 CLAIMS-MADE OCCUR MED.EXP(Any one person) $ 5,000 • XCU/OCP/BFPD PERSONAL&ADV INJURY $ 1,000,000 • Separation of Insureds GENERAL AGGREGATE $ 2,090,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PE° LOC i $ Q AUTOMOBILE LIABILITY BA614BN401 05129112 05129113 COMBINED LIMIT $ 11090,900 I X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS IPN aooIs a C UMBRELLA LAB X OCCUR CUP3196T698 05129/12 05/29113 EACH OCCURRENCE $ 5,000,000 EXCESS LIMB CLAIMS-MADE AGGREGATE $ 51000,000 DED, X RETENTION E 10,000 $ WORKERS COMPENSATION WL ST ITo- OTH AND EMPLOYERS' LABILITY TGRYLIMITS ER $ ANY PROPRIETOR/PARTNER/ECECUTIVE YIN E.L.EACH ACCIDENT $ OFFICE EMBER EXCLUDED? ICI NIA iM.omw,y In NH) E.L.DISEASE-EA EMPLOYEE $ If Yes.di be xxAP DESCRIPTION OF OPERATIONS EeIUw - "- - - — - - E.L.DISEASE-POLICY LIMIT- _ $ A Professional Liability:Claims Woe Form 105320158 07/26/11 07/26/12 $1,000,000 Per Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,B more space Is required) Project:Schofield/Monte Vista LID Project No.2005-08 City of Ashland,Oregon and its elected officials,officers and employees are Additional Insured on the Commercial General Liability and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured.The Commercial General Liability insurance is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance.A waiver of subrogation applies to the Commercial General Liability,Auto Liability and Umbrella I Excess in favor of the Additional Insured CERTIFICATE HOLDER (� CANCELLATION D E G rE U IV rz - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main St 1' ACCORDANCE WITH THE POLICY PROVISIONS. [ Ashland,OR 97520-1814 MAY Z J 2012 AUTHORIZED REPRESENTATIVE Attention: James H.Disc Aime Carroll ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED INSURANCE (Section III) for this Coverage (Section ll): Part. Any person or organization that you agree in a B. The following is added to Paragraph a. of 4. "contract or agreement requiring insurance" to in- Other Insurance in COMMERCIAL GENERAL clude as an additional insured on this Coverage LIABILITY CONDITIONS (Section IV): Part, but only with respect to liability for"bodily in- However, if you specifically agree in a "contract or jury", "property damage" or "personal injury" agreement requiring insurance"that the insurance caused, in whole or in part, by your acts or omis- provided to an additional insured under this Cov- sions or the acts or omissions of those acting on erage Part must apply on a primary basis, or a your behalf: primary and non-contributory basis,this insurance a. In the performance of your ongoing opera- is primary to other insurance that is available to tions; such additional insured which covers such addi- b. In connection with premises owned by or tional insured as a named insured,and we will not rented to you;or share with the other insurance, provided that: c. In connection with "your work" and included (1) The "bodily injury" or "property damage" for within the "products-completed operations which coverage is sought occurs; and hazard". (2) The "personal injury" for which coverage is Such person or organization does not qualify as sought arises out of an offense committed; an additional insured for "bodily injury", "property after you have entered into that "contract or damage" or "personal injury" for which that per- agreement requiring insurance". But this insur- son or organization has assumed liability in a con- ance still is excess over valid and collectible other tract or agreement. insurance, whether primary, excess, contingent or The insurance provided to such additional insured on any other basis, that is available to the insured is limited as follows: when the insured is an additional insured under d. This insurance does not apply on any basis to any other insurance. any person or organization for which cover- C. The following is added to Paragraph 8. Transfer age as an additional insured specifically is Of Rights Of Recovery Against Others To Us added by another endorsement to this Cover- in COMMERCIAL GENERAL LIABILITY CON- age Part. DITIONS(Section IV): e. This insurance does not apply to the render- We waive any rights of recovery we may have ing of or failure to render any "professional against any person or organization because of services". payments we make for "bodily injury",y � 1 rY", "property f. The limits of insurance afforded to the addi- damage" or "personal injury" arising out of "your tional insured shall be the limits which you work" performed by you, or on your behalf, under agreed in that "contract or agreement requir- a "contract or agreement requiring insurance"with ing insurance" to provide for that additional that person or organization. We waive these insured, or the limits shown in the Declara- rights only where you have agreed to do so as tions for this Coverage Part, whichever are part of the"contract or agreement requiring insur- less. This endorsement does not increase the ance" with such person or organization entered limits of insurance stated in the LIMITS OF into by you before, and in effect when, the "bodily CG D3 81 09 07 ©2007 The Travelers Companies,Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc.,with its permission COMMERCIAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- erage Part, provided that the "bodily injury" and sonal injury"offense is committed. "property damage" occurs, and the "personal in- D. The following definition is added to DEFINITIONS jury"is caused by an offense committed: (Section V): a. After you have entered into that contract or "Contract or agreement requiring insurance" agreement; means that part of any contract or agreement un- b. While that part of the contract or agreement is der which ydu are required to include a person or in effect; and organization as an additional insured on this Cov- c. Before the end of the policy period. Page 2 of 2 ®2007 The Travelers Companies,Inc. CG D3 8109 07 Includes the copyrighted material of Insurance Services Office, Inc.,with its permission i COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorse- (d) Costs for extended warranties, Credit Life ment, the provisions of the Coverage Form apply Insurance, Health, Accident or Disability unless modified by the endorsement. Insurance purchased with the loan or A. PERSONAL EFFECTS COVERAGE lease; and SECTION III — PHYSICAL DAMAGE COVER- (e) Carry-over balances from previous loans AGE, A. Coverage, 4. Coverage Extensions is or leases. amended by adding the following: C. COVERAGE EXTENSION — AUDIO, VISUAL Personal Effects Coverage AND DATA ELECTRONIC EQUIPMENT NOT We will pay up to $400 for "loss" to wearing ap- DESIGNED SOLELY FOR THE PRODUCTION parel and other personal effects which are: OF SOUND SECTION 111 — PHYSICAL DAMAGE COVER- (1) owned by an"insured"; and AGE, B. Exclusions, exception paragraph a. to (2) in or on your covered "auto"; exclusions 4.c & 4.d is deleted and replaced with . in the event of a total theft "loss" of your covered the following: "auto". a. Equipment and accessories used with such No deductibles apply to Personal Effects Cover- equipment, except tapes, records or discs, age. provided such equipment is permanently in- B. AUTO LOAN LEASE GAP COVERAGE stalled in the covered "auto"at the time of the "loss" or is removable from a housing unit SECTION III — PHYSICAL DAMAGE COVER- which is permanently installed in the covered AGE, A. Coverage, 4. Coverage Extensions is auto" at the time of the "loss", and such amended by adding the following: equipment is designed to be solely operated Auto Loan Lease Gap Coverage for Private by use of the power from the "auto's" electri- Passenger Type Vehicles cal system, in or upon the covered "auto"; or In the event of a total "loss"to a covered "auto"of D. WAIVER OF DEDUCTIBLE—GLASS the private passenger type shown in the Schedule SECTION III — PHYSICAL DAMAGE COVER. or Declarations for which Physical Damage Cov- AGE, D. Deductible is amended by adding the erage is provided, we will pay any unpaid amount following: due on the lease or loan for such covered "auto" less the following: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than (1) The amount paid under the Physical Damage replaced. Coverage Section of the policy for that"auto"; and E. HIRED AUTO PHYSICAL DAMAGE COVER- AGE (2) Any: SECTION III — PHYSICAL DAMAGE COVER- (a) Overdue lease/loan payments at the time AGE, A. Coverage, 4. Coverage Extensions is of the "loss"; amended by adding the following: (b) Financial penalties imposed under a Hired Auto Physical Damage Coverage Exten- lease for excessive use, abnormal wear sion and tear or high mileage; If hired "autos" are covered "autos" for Liability (c) Security deposits not returned by the les- Coverage and this policy also provides Physical sor; Damage Coverage for an owned "auto", then the CA T4 20 07 06 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. Page 1 of 2 Includes the copyrighted material of The St.Paul Travelers Companies, Inc. COMMERCIAL AUTO Physical Damage Coverage is extended to ' tent required of you by a written contract exe- "autos"that you hire, rent or borrow subject to the cuted prior to any "accident" or "loss", pro- following: vided that the"accident"or"loss"arises out of (1) The most we will pay for"loss" in any one the operations contemplated by such con- "accident" to a hired, rented or borrowed tract. The waiver applies only to the person or "auto"is the lesser of: organization designated in such contract (a) $50,000; G. BLANKET ADDITIONAL INSURED (b) The actual cash value of the dam- SECTION II— LIABILITY COVERAGE, part A. 1. aged or stolen property as of the time Who Is An Insured, paragraph c. is amended by of the"loss"; or adding the following: (c) The cost of repairing or replacing the Any person or organization that you are required damaged or stolen property with to include as an additional insured on this Cover- other property of like kind and quality. age Form in a written contract or agreement that is signed and executed by you before the "bodily (2) An adjustment for depreciation and injury" or"property damage" occurs and that is in physical condition will be made in deter- mining actual cash value in the event of a effect during the policy period is an "insured" for Liability Coverage, but only for damages to which total"loss". this insurance applies and only to the extent that (3) If a repair or replacement results in better person or organization qualifies as an "insured" than like kind or quality, we will not pay under the Who Is An Insured provision contained for the amount of betterment. in Section 11. (4) A deductible equal to the highest Physical H. EMPLOYEE HIRED AUTOS Damage deductible applicable to any SECTION 11 — LIABILITY COVERAGE, A. Cov- owned covered "auto". erage, 1. Who Is An Insured is amended by add. (5) This Coverage Extension does not apply ing the following: to: An "employee" of yours is an "insured" while op- (a) Any"auto"that is hired, rented or bor- erating an "auto" hired or rented under a contract rowed with a driver, or or agreement in that "employee's" name, with (b) Any"auto"that is hired, rented or bor- your permission, while performing duties related rowed from your"employee". to the conduct of your business. F. BLANKET WAIVER OF SUBROGATION 1. COVERAGE EXTENSION—TRAILERS SECTION IV—BUSINESS AUTO CONDITIONS, SECTION I — COVERED AUTOS, C. Certain A. Loss Conditions, 5. Transfer Of Rights Of Trailers, Mobile Equipment and Temporary Recovery Against Others To Us is deleted and Substitute Autos, paragraph 1. is deleted and replaced by the following: replaced by the following: 5.' Trarisfei Of Rights Of Recovery Agains£ 1. "Trailers" with a load`capacity of" 3;000 Others To Us pounds or less designed. primarily for travel We waive any right of recovery we may have on public roads. against any person or organization to the ex Page 2 of 2 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. CA T4 20 07 06 Includes the copyrighted material of The St.Paul Travelers Companies, Inc.