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HomeMy WebLinkAboutInsurance Certificate: Greg Covery LLC GREGCOV-01 KAMMIRATA ,4coR0 CERTIFICATE OF LIABILITY INSURANCE O 111201201 YY) ~i z 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. 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 CONTACT NAME: DBA: Western States Insurance Agency of Medford PHONE 779-1$21 FAx Western States Insurance Agency, Inc. ALAN 1(541) uc, NO : (541) 779-9187 38 North Central Ave. ADDRESS: ed Mforrdd, , OR 97501 INSURER(S) AFFORDING COVERAGE NAILS Medford, INSURER A ; First Nail Ins Co of America INSURED INSURER B Greg Covey LLC INSURER C Gregory T. Covey 295 E Main St # 8 INSURER D Ashland, OR 97520 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. INSR TYPE OF INSURANCE POLICY NUMBER MM DCDIYYYY MMIDCDIYYYY LIMITS INSR MD TR GENERAL LIABILITY I EACH OCCURRENCE 8 1r000rOOO A X COMMERCIAL GENERAL LIABILITY X 010128451140 111241201211112412013 PDAM REMISES Ea occurrence f 200,000 Fv7 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acddeni ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS PER ACCIDENT $ UMBRELLA LIAB OCCUR EACH OCCURRENCE- $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION WC STATU- I OTH- TORY LIMITS; I ER -AND EMPLOYERS' LIATILITY__. YIN AFFICER EMBER EXCLUDED' CUTIVE NIA E.L. EACH ACCIDENT $ (Mandan )EXCLUDED? (Mandatory ry In in N NH) j E.L. DISEASE - EA EMPLOYE E If yes, descmpe under DESCRIPTION OF OPERATIONS below E.L. DISEASEPOLICY LIMIT~$ i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more space is required) Project: Landscape Design Services for the Plaza in Downtown Ashland. The City of Ashland, OR and its elected officials, officers 8 employees as additional insureds on the ppolicy required herein but only with respect to Consultant's Services to be provided under this contract. The policy is preimary and non contributory per CG76801002 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CG 76 80 10 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION II - WHO IS AN INSURED is amended you. Coverage shall be limited to the extent of your to include as an additional insured the person or negligence or fault according to the applicable princi- organization shown in the Schedule subject to the ples of comparative fault+ following provisions: 1. The additional insured is an insured but only for The insurance provided will not exceed the lesser of: liability directly resulting from: a. The coverage and/or limits of this policy, or a. your ongoing operations for the additional in- b. The coverage and/or limits required by the sured whether the work is performed by you contract, agreement or permit. or for you; or b. the general supervision of our ongoing - With respect to the insurance afforded the additional erations general the additional insured. op- insured, paragraph 4. of SECTION IV - COMMER- CIAL GENERAL LIABILITY CONDITIONS is de- 2. This insurance does not apply to: leted and replaced by the following: a. "Bodily injury" or "property damage" arising 4. Other Insurance out of any act or omission of, or for defects a This insurance is in design furnished by or for, the additional primary and noncontrib- insured or utory, and our obligations are not affected by any other insurance where the additional in- b. "Bodily injury" or "property damage" in- sured is the Named Insured, whether pri- cluded within the "products-completed oper- mary, excess, contingent, or on any other ations hazard." basis; however, the defense of any claim or "suit" must be tendered as soon as practi- A person's or organization's status as an additional cable to all other insurers which potentially insured under this endorsement ends when your op- provide insurance for such claim or "suit". erations for that insured are completed. b. This additional provision applies only to the No coverage will be provided if, in the absence of this additional insured shown in the Schedule endorsement, no liability would be imposed by law on and the coverage provided by this endorse- ment. CG 76 60 10 02 EP