HomeMy WebLinkAboutInsurance Certificate: Kittelson & Associates
Client: 763494 K117EASC
ACORD CERTIFICATE OF LIABILITY INSURANCE DATr1YYY
1v20/20zo/201 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: N the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. It 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
"ME:
FCC-
Kibble & Prentice, a USI Co PR PHONE 206 441-6300
a/c No Ell: ,c No: 610-362-8528
601 Union Street, Suite 1000 E-MAIL
ADDRESS: PL.Certrequest@kPeom.com
Seattle, WA 98101 INSURER(S) AFFORDING COVERAGE NAICA
INSURER A: Hartford Casualty Insurance Com 29424
INSURED INSURER B : Travelers Casualty and Surety o 31194
Kittelson & Associates, Inc. INSURER C: XL Specialty Insurance Company 37885
610 SW Alder Street Suite 700 Hartford Underwriters Insurance 30104
Portland, OR 97205 INSURER D:
INSURER E
"SURER 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 CONTRACTOR 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.
LTR TYPE OF INSURANCE NADDLSUBR SR WD POLICY NUMBER M IDDY EFF MWDCDFYYYP LIMITS
A GENERAL LIABILITY 52SBAU05445 1/01/2013 01/01/201 EACH
~ ~OCCURRENCE $1 000000
COMMERCIAL GENERAL LIABILITY PREk115E5 EEe
aNN".' a 5300000
CLAIMS-MADE F-ROCCUR MED EXP("one person) $10000
X Business Liability PERSONAL &ADV INJURY $1000000
GEN ERAL AGGREGATE s2,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000,000
POLICY X 20- LOC $
D AUTOMOBILE LIABILITY 52UECVZ2830 1/01/2013 01/01/201 E°ammeDlsINGLE LIMIT 1,000,000
X ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (PeramdenD $
AUTOS AUTOS
X HIRED AUTOS X NON-0WNED PROPERtt DAMAGE S
AUTOS Per ettidenl
$
UMBRELLA LIAR OCCUR EACHOCCURRENCE $
EXCESS UAB CLAIMS-MADE AGGREGATE $
DED RETENTIONS $
OTH
B WORKERS COMPENSATION UB4002T187 1/01/2013 01/01/201 X T STATU- -
AND EMPLOYERS' LIABILITY
B OFFICENMEMBER EXCLUDED]ECUTIVE N/A UB4002T612 El. EACH ACCIDENT $1 000 ,000 YIN (Mandatory In NM E.L. DISEASE - EA EMPLOYEE $1000000
II yea desomee tester
DESCRIPTION OF OPERATIONS W1. E.L. DISEASE - POLICY LIMIT $1000000
C Professional DPR9704439 2/3012012 12/30/201 $2,000,000 per claim
Liability $4,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more apace Is required)
Re: Job 11310.2; N. Main Road Diet Engineering services.
The General Liability policy Includes a blanket automatic Additional Insured endorsement that provides
Additional Insured status to the The City of Ashland, Oregon and its elected officials, officers, and
employees only when there is a written contract or written agreement between the named insured and the
certificate holder that requires such status, and only with regard to work performed on behalf of the named
Insured and Including primary and non contributory wording and waiver of subrogation.
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 East Mein St. ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97520
AUTHORIZED REPRESENTATIVE
0 1 98 8-201 0 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 Off The ACORD name and logo are registered marks of ACORD
1lS9146907/M9138235 VKWZP
Policy #52SBAUQ5445 BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, in the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to:
control is being exercised for any (1) "Bodily injury" or "property damage"
purpose by you, any of your that occurred; or
"employees", "volunteer workers",
any partner or member (if you are (2) "Personal and advertising injury" o
a partnership or joint venture), or arising out of an offense committed
any member (if you are a limited before you acquired or formed the
liability company). organization.
b. Real Estate Manager 4. Operator Of Mobile Equipment
Any person (other than your "employee" or With respect to "mobile equipment" registered in
"volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an insured while driving such
c. Temporary Custodians Of Your equipment along a public highway with your
Property permission. Any other person or organization
responsible for the conduct of such person is
Any person or organization having proper also an insured, but only with respect to liability
temporary custody of your property if you arising out of the operation of the equipment, and
die, but only: only if no other insurance of any kind is available
(1) With respect to liability arising out of the to that person or organization for this liability.
maintenance or use of that property; and However, no person or organization is an insured
(2) Until your legal representative has with respect to:
been appointed. a. "Bodily injury" to a co-"employee" of the
d. Legal Representative If You Die person driving the equipment; or
Your legal representative if you die, but b. "Property damage" to property owned by,
only with respect to duties as such. That rented to, in the charge of or occupied by
representative will have all your rights and you or the employer of any person who is
duties under this insurance. an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that
yours which is a legally incorporated entity is less than 51 feet long and is not being used
of which you own a financial interest of to carry persons for a charge, any person is an
more than 50% of the voting stock on the insured while operating such watercraft with
effective date of this Coverage Part. your permission. Any other person or
The insurance afforded herein for any organization responsible for the conduct of
subsidiary not shown in the Declarations such person is also an insured, but only with
as a named insured does not apply to respect to liability arising out of the operation
the
injury or damage with respect to which an insurance of watercraft, and only no other
insured under this insurance is also an any kind is available to that
insured under another policy or would be person or organization for this liability.
an insured under such policy but for its However, no person or organization is an
termination or upon the exhaustion of its insured with respect to:
limits of insurance. a. 'Bodily injury" to a co-"employee" of the
3. Newly Acquired Or Formed Organization person operating the watercraft; or
Any organization you newly acquire or form, b. "Property damage" to property owned by,
other than a partnership, joint venture or rented to, in the charge of or occupied by
limited liability company, and over which you you or the employer of any person who is
maintain financial interest of more than 50% of an insured under this provision.
the voting stock, will quality as a Named 6. Additional Insureds When Required By
Insured if there is no other similar insurance Written Contract, Written Agreement Or
available to that organization. However: Permit.
a. Coverage under this provision is afforded The person(s) or organization(s) identified in
only until the 180th day after you acquire Paragraphs a. through f. below are additional
or form the organization or the end of the insureds when you have agreed, in a written
policy period, whichever is earlier; and
Form SS 00 08 04 05 Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (e) Any failure to make such
permit issued by a state or political inspections, adjustments, tests or
subdivision, that such person or organization servicing as the vendor has
be added as an additional insured on your agreed to make or normally
policy, provided the injury or damage occurs undertakes to make in the usual
subsequent to the execution of the contract or course of business, in connection
agreement, or the issuance of the permit. with the distribution or sale of the
A person or organization is an additional products;
insured under this provision only for that (f) Demonstration, installation,
period of time required by the contract, servicing or repair operations,
agreement or permit. except such operations performed
However, no such person or organization is an at the vendor's premises in
additional insured under this provision if such connection with the sale of the
person or organization is included as an product;
additional insured by an endorsement issued (9) Products which, after distribution
by us and made a part of this Coverage Part, or sale by you, have been labeled
including all persons or organizations added or relabeled or used as a
as additional insureds under the specific container, part or ingredient of any
additional insured coverage grants in Section other thing or substance by or for
F. - Optional Additional Insured Coverages. the vendor; or
a. Vendors (h) "Bodily injury" or "property
Any person(s) or organization(s) (referred to damage" arising out of the sole
below as vendor), but only with respect to negligence of the vendor for its
"bodily injury" or "property damage" arising own acts or omissions or those
e
out of "your products" which are distributed its employees or anyone else
However, this
or sold in the regular course of the vendors exclusion its does not behalf. apply to:
business and only If this Coverage Part
provides coverage for "bodily injury" or (1) The exceptions contained in
"property damage" included within the Subparagraphs (d) or (f); or
"products-completed operations hazard". (ii) Such inspections, adjustments,
(1) The insurance afforded to the vendor tests or servicing as the vendor
is subject to the following additional has agreed to make or normally
exclusions: undertakes to make in the usual
course of
This insurance does not apply to: business, in
connection with the distribution
(a) "Bodily injury" or "property or sale of the products.
damage" for which the vendor is
obligated to pay damages by (2) This insurance does not apply to any
reason of the assumption of insured person organization from
liability in a contract or agreement. whom you have acquired such products,
This exclusion does not apply to or any ingredient, part container,
entering into, accompanying or
liability for damages that the containing such products.
vendor would have in the absence
of the contract or agreement; b. Lessors Of Equipment
(b) Any express warranty (1) Any person or organization from
unauthorized by you; whom you lease equipment; but only
(c) Any physical or chemical change with respect to their liability for "bodily
inj
in the product made intentionally injury", "property damage" or
by the vendor; "personal and advertising injury"
caused, in whole or in part, by your
(d) Repackaging, except when maintenance, operation or use of
unpacked solely for the purpose of equipment leased to you by such
inspection, demonstration, testing, person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the insurance afforded e. Permits Issued By State Or Political
to these additional insureds, this Subdivisions
insurance does not apply to any (1) Any state or political subdivision, but
'.occurrence" which takes place after only with respect to operations _
you cease to lease that equipment. performed by you or on your behalf for
c. Lessors Of Land Or Premises which the state or political subdivision
(1) Any person or organization from has issued a permit.
whom you lease land or premises, but (2) With respect to the insurance afforded
only with respect to liability arising out to these additional insureds, this
of the ownership, maintenance or use insurance does not apply to:
of that part of the land or premises (a) "Bodily injury",
leased to you. Y "Property damage"
or "personal l and advertising
(2) With respect to the insurance afforded injury" arising out of operations
to these additional insureds, this performed for the state or
insurance does not apply to: municipality; or
(a) Any "occurrence" which takes (b) "Bodily injury" or "property damage"
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises; or I. Any Other Party
(b) Structural alterations, new (1) Any other person or organization who
construction or demolition is not an insured under Paragraphs a.
operations performed by or on through e. above, but only with
behalf of such person or respect to liability for "bodily injury",
organization. .'property damage" or "personal and
d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or
(1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or
only with respect to liability for "bodily the acts or omissions of those acting
injury", "property damage" or "personal on your behalf:
and advertising injury" caused, in whole (a) In the performance of your
or in part, by your acts or omissions or ongoing operations;
the ads or omissions of those acting on
remises
(b) connection with
your behalf: owned by o
rented to o you; o
(a) In connection with your premises; (c) In connection with "your work" and
or included within the "products-
(b) In the performance of your completed operations hazard", but
ongoing operations performed by only if
you or on your behalf.
(1) The written contract or written
(2) With respect to the insurance afforded agreement requires you to
to these additional insureds, the provide such coverage to
following additional exclusion applies: such additional insured; and
This insurance does not apply to (ii) This Coverage Part provides
"bodily injury", "property damage" or coverage for "bodily injury" or
"personal and advertising injury" '.property damage" included
arising out of the rendering of or the within the "products-
failure to render any professional completed operations hazard".
services by or for you, including: (2) With respect to the insurance afforded
(a) The preparing, approving, or to these additional insureds, this
failure to prepare or approve, insurance does not apply to:
maps, shop drawings, opinions, "Bodily injury", "
reports, surveys, field orders, " Y Property damage" or
change orders, designs or personal and advertising injury"
arising out of the rendering of, or the
drawings and specifications; or failure to render, any professional
(b) Supervisory, inspection, architectural, engineering or surveying
architectural or engineering services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or This General Aggregate limit does not
failure to prepare or approve, apply to "property damage" to premises
maps, shop drawings, opinions, while rented to you or temporarily
reports, surveys, field orders, occupied by you with permission of the
change orders, designs or owner, arising out of fire, lightning or
drawings and specifications; or explosion.
(b) Supervisory, inspection, 3. Each Occurrence Limit
architectural or engineering Subject to 2.a. or 2.b above, whichever
activities. applies, the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all "bodily injury",
insureds are described in Section D. - Limits "property damage" and medical expenses
Oflnsurance. arising out of any one "occurrence" is the
How this insurance applies when other Liability and Medical Expenses Limit shown in
insurance is available to an additional insured the Declarations.
is described in the Other Insurance Condition The most we will pay for all medical expenses
in Section E. - Liability And Medical Expenses because of "bodily injury" sustained by any
General Conditions. one person is the Medical Expenses Limit
No person or organization is an insured with shown in the Declarations.
respect to the conduct of any current or past 4. Personal And Advertising Injury Limit
partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for
company that is not shown as a Named Insured in the sum of all damages because of all
the Declarations.
"personal and advertising injury" sustained by
D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal
LIMITS OF INSURANCE and Advertising Injury Limit shown in the
Declarations.
1. The Most We Will Pay
5. Damage To Premises Rented To You Limit
The Limits of Insurance shown in the
Declarations and the rules below fix the most The Damage To Premises Rented To You
we will pay regardless of the number of: Limit is the most we will pay under Business
Liability Coverage for damages because of
a. Insureds; "property damage" to any one premises, while
b. Claims made or "suits" brought; or rented to you, or in the case of damage by fire,
c. Persons or organizations making claims or lightning or explosion, while rented to you or
bringing "suits". temporarily occupied by you with permission of
2. Aggregate Limits the owner.
The most we will pay for: In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
a. Damages because of "bodily injury" and You Limit applies to all damage proximately
"property damage" included in the caused by the same event, whether such
"products-completed operations hazard" is damage results from fire, lightning or explosion
the Products-Completed Operations or any combination of these.
Aggregate Limit shown in the
Declarations 6. How Limits Apply To Additional Insureds
.
b. Damages because of all other "bodily The most we will pay on behalf of a person or
injury", "property damage" or "personal organization who is an additional insured
and advertising injury", including medical under this Coverage Part is the lesser of:
expenses, is the General Aggregate Limit a. The limits of insurance specified in a
shown in the Declarations. written contract, written agreement or
This General Aggregate Limit applies permit issued by a state or political
separately to each of your "locations" subdivision; or
owned by or rented to you. b. The Limits of Insurance shown in the
"Location' means premises involving the Declarations.
same or connecting lots, or premises Such amount shall be a part of and not in
whose connection is interrupted only by a addition to the Limits of Insurance shown in
street, roadway or right-of-way of a the Declarations and described in this Section.
railroad.
Page 14 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance under this (1) Immediately send us copies of any
policy and any endorsements attached thereto demands, notices, summonses or
applies to any claim or "suit", the most we will pay legal papers received in connection
under this policy and the endorsements is the with the claim or "suit"; _
single highest limit of liability of all coverages (2) Authorize us to obtain records and
applicable to such claim or "suit". However, this other information; -
paragraph does not apply to the Medical Expenses o
limit set forth in Paragraph 3. above. (3) Cooperate with us in the investigation,
settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply against the "suit"; and
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting (4) Assist us, upon our request, i the
with the beginning of the policy period shown in the enforcement of any right against t any
Declarations, unless the policy period is extended person or organization that may be
after issuance for an additional period of less than 12 liable to the insured because of injury
or damage which this insurance
months. In that case, the additional period will be may also apply.
deemed part of the last preceding period for purposes
of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own
GENERAL CONDITIONS cost, voluntarily make a payment, assume
any obligation, or incur any expense, other
1. Bankruptcy than for first aid, without our consent.
Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance
the insured's estate will not relieve us of our If we cover a claim or "suit" under this
obligations under this Coverage Part. Coverage Part that may also be covered
2. Duties In The Event Of Occurrence, by other insurance available to an
Offense, Claim Or Suit additional insured, such additional insured
a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the
You or any additional insured must see to other insurer for defense and indemnity.
it that we are notified as soon as However, this provision does not apply to
practicable of an "occurrence" or an the extent that you have agreed in a
offense which may result in a claim. To written contract, written agreement or
the extent possible, notice should include: permit that this insurance is primary and
non-contributory with the additional
(1) How, when and where the "occurrence" insured's own insurance.
or offense took place;
f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any Claim Or Suit
injured persons and witnesses; and
Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury any additional insured only when such
or damage arising out of the "occurrence", offense, claim or "suit" is
"occurrence" or offense. known to:
b. Notice Of Claim
(1) You or any additional insured that is
If a claim is made or "suit" is brought an individual;
against any insured, you or any additional (2) Any partner, if you or an additional
insured must: insured is a partnership;
(1) Immediately record the specifics of the (3) Any manager, if you or an additional
claim or "suit" and the date received; insured is a limited liability company;
and
(2) Notify us as soon as practicable. (4) Any "executive officer" insurance
manager, if you or an n additional
You or any additional insured must see to insured is a corporation;
it that we receive a written notice of the (5) Any trustee, if you or an additional
claim or "suit" as soon as practicable. insured is a trust; or
c. Assistance And Cooperation Of The 5
Insured Any elected or appointed official, if you
or an additional insured is a political
You and any other involved insured must: subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to (3) We have issued this policy in reliance
you and any additional insured. upon your representations.
3. Financial Responsibility Laws b. Unintentional Failure To Disclose
a. When this policy is certified as proof of Hazards
financial responsibility for the future under If unintentionally you should fail to disclose
the provisions of any motor vehicle all hazards relating to the conduct of your
financial responsibility law, the insurance business at the inception date of this
provided by the policy for "bodily injury" Coverage Part, we shall not deny any
liability and "property damage" liability will coverage under this Coverage Part
comply with the provisions of the law to because of such failure.
the extent of the coverage and limits of 7, Other Insurance
insurance required by that law.
If other valid and collectible insurance is
b. With respect to "mobile equipment" to available for a loss we cover under this
which this insurance applies, we will Coverage Part, our obligations are limited as
provide any liability, uninsured motorists,
follows:
underinsured motorists, no-fault or other
coverage required by any motor vehicle a. Primary Insurance
law. We will provide the required limits for This insurance is primary except when b.
those coverages. below applies. If other insurance is also
4. Legal Action Against Us primary, we will share with all that other
No person or organization has a right under insurance by the method described in c.
below.
this Coverage Form:
a. To join us as a party or otherwise bring us b. Excess Insurance
into a "suit" asking for damages from an This insurance is excess over any of the
insured; or other insurance, whether primary, excess,
b. To sue us on this Coverage Form unless contingent or on any other basis:
all of its terms have been fully complied (1) Your Work
with. That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or
on an agreed settlement or on a final judgment similar coverage for "your work";
against an insured; but we will not be liable for (2) Premises Rented To You
damages that are not payable under the terms of
this insurance or that are in excess of the That is fire, lightning or explosion
applicable limit of insurance. An agreed insurance for premises rented to you
settlement means a settlement and release of or temporarily occupied by you with
liability signed by us, the insured and the permission of the owner;
claimant or the claimant's legal representative. (3) Tenant Liability
5. 'Separation Of Insureds' That is insurance purchased by you to
Except with respect to the Limits of Insurance, cover your liability as a tenant for
and any rights or duties specifically assigned "property damage" to premises rented
in this policy to the first Named Insured, this to you or temporarily occupied by you
insurance applies: with permission of the owner;
a. As if each Named Insured were the only (4) Aircraft, Auto Or Watercraft
Named Insured; and If the loss arises out of the maintenance
b. Separately to each insured against whom or use of aircraft, "autos" or watercraft to
a claim is made or "suit" is brought. the extent not subject to Exclusion g. of
6. Representations Section A. - Coverages.
a. When You Accept This Policy (5) Property Damage To Borrowed
y Equipment Or Use Of Elevators
By accepting this policy, you agree: If the loss arises out of "property
(1) The statements in the Declarations damage" to borrowed equipment or
are accurate and complete; the use of elevators to the extent not
(2) Those statements are based upon subject to Exclusion k. of Section A. -
representations you made to us; and Coverages.
Page 16 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An When this insurance is excess over other
Additional Insured To Other insurance, we will pay only our share of
Insurance the amount of the loss, if any, that
That is other insurance available to exceeds the sum of:
you covering liability for damages (1) The total amount that all such other
arising out of the premises or insurance would pay for the loss in the
operations, or products and completed absence of this insurance; and
operations, for which you have been (2) The total of all deductible and self-
added as an additional insured by that insured amounts under all that other
insurance; or insurance.
(7) When You Add Others As An We will share the remaining loss, if any, with
Additional Insured To This any other insurance that is not described in
Insurance this Excess Insurance provision and was not
That is other insurance available to an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown in the
However, the following provisions Declarations of this Coverage Part.
apply to other insurance available to c. Method Of Sharing
any person or organization who is an If all the other insurance
permits
additional insured under this Coverage contribution by equal shares, we will follow
Part: this method also. Under this approach,
(a) Primary Insurance When each insurer contributes equal amounts
Required By Contract until it has paid its applicable limit of
This insurance is primary if you insurance or none of the loss remains,
have agreed in a written contract, whichever comes first.
written agreement or permit that If any of the other insurance does not permit
this insurance be primary. If other contribution by equal shares, we will
insurance is also primary, we will contribute by limits. Under this method, each
share with all that other insurance insurers share is based on the ratio of its
by the method described in c. applicable limit of insurance to the total
below. applicable limits of insurance of all insurers.
(b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against
To Other Insurance When Others To Us.
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed in a written If the insured has rights to recover all or
contract, written agreement or
permit that this insurance is part of any payment, including
Supplementary Payments, we have made
primary and non-contributory with under this Coverage Part, those rights are
the additional insured's own transferred to us. The insured must do
insurance, this insurance is nothing after loss to impair them. At our
primary and we will not seek request, the insured will bring "suit" or
contribution from that other transfer those rights to us and help us
insurance. enforce them. This condition does not
Paragraphs (a) and (b) do not apply to apply to Medical Expenses Coverage.
other insurance to which the additional b. Waiver Of Rights Of -Recovery (Waiver
insured has been added as an Of Subrogation)
additional insured.
If
When this insurance is excess, we will the insured has waived any rights of
have no duty under this Coverage Part to recovery against any person or
defend the insured against any "suit" if any organization for all or part of any payment,
including Supplementary Payments, we
other insurer has a duty to defend the have made under this Coverage Part, we
insured against that "suit". If no other also waive that right, provided the insured
insurer defends, we will undertake to do waived their rights of recovery against
so, but we will be entitled to the insured's such person or organization in a contract,
rights against all those other insurers. agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
Client#: 763494 KITTEASC
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (M/20/YYVY)
12/20/2012
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 COMA
NAME:
Kibble & Prentice, a US[ Cc PR PHONE 206 441-6300 A 15
601 Union Street, Suite 1000 E MAIIL Ea : ac, No: 610-362-8528
Seattle, WA 98101 ADDRESS: PL•Certrequest@kpeom.com
INSURER(S) AFFORDING COVERAGE NAICI
INSURER A. Hartford Casualty Insurance Com 29424
INSURED Kittelson & Associates, INSURER B: Travelers Casualty and Surety o 31194
Inc.
610 SW Alder Street Suite 700 INSURER c: XL Specialty Insurance Company 37885
Portland, OR 97205 INSURER D: Hartford Underwriters Insurance 7~1
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 CONTRACTOR 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 ADDL'SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE IN SR MD POLICY NUMBER MMIDDNYYY MWDD/YYY LIMITS
A GENERAL LIABILITY 52SBAU05445 1/01/2013 01/01/201 EACH OCCURRENCE s1 LIDO OLIO
COMMERCIAL GENERAL LIABILITY PREMISES Egq aEaNNTUEAD. $300000
CLAIMS-MADE Fx~ OCCUR MED EXP(An, one person) $10000
X Business Liability PERSONAL &ADV INJURY $1000000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG 62,000,000
]JECT F-1 PRO- LOC $
POLICY X
D AUTOMOBILEkIABILITY 52UECVZ2830 1/01/2013 01/01/201 COMBINED SINGLE LIMIT
Ea accidem 1,000,000
X ANY AUTO BODILY INJURY (Per Person) S
ALLOWNEO SCHEDULED
AUTOS AUTOS BODILY INJURY (Per accident) $
X HIRED AUTOS X NON-0WNED PROPERTY DAMAGE $
AUTOS Peramltlent
s
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE AGGREGATE $
BED RETENTION$ $
B WORKERS COMPENSATION UB4002T187 1/01/2013 01/01/201 X We ST%uT 9TH
AND EMPLOYERS' LIABILITY
B My PROrt&EMBOERPFXGWDEDp ECUTIVE-1 N/A UB4002T612 E.L. EACH ACCIDENT $1000ODD
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $1,000,000
If yet, OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1.000.000
C Professional DPR9704439 2/3012012 12130/201 $2,000,000 per claim
Liability $4,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
RE: KAI PN 11310, Project #11310.06.
The General Liability and Automobile Liability policies include a blanket automatic Additional Insured
endorsement that provides Additional Insured status to the Certificate holder, Oregon, and its elected
officials, officers, and employees, only when there is a written contract or written agreement between the
named insured and the certificate holder that requires such status, and only with regard to work performed
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97520
AUTHORIZED REPRESENTATIVE
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD
#S9146908/M9138235 VKWZP
DESCRIPTIONS (Continued from Page 1)
on behalf of the named insured. The General Laibility policy contains a special endorsement with Primary
and Noncontributory wording.
. .M, ,.s
r
SAGITTA 25.3 (2010/05) 2 of 2
#59146908/M9138235
Policy #52SBAUQ5445 BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, in the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to:
control is being exercised for any (1) "Bodily injury" or "property damage"
purpose by you, any of your that occurred; or
"employees", "volunteer workers",
any partner or member (if you are (2) "Personal and advertising injury"
a partnership or joint venture), or arising out of an offense committed
any member (if you are a limited before you acquired or formed the
liability company). organization.
b. Real Estate Manager 4. Operator Of Mobile Equipment
Any person (other than your "employee" or With respect to "mobile equipment' registered in
"volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an insured while driving such
c. Temporary Custodians Of Your equipment along a public highway with your
Property permission. Any other person or organization
responsible for the conduct of such person is
Any person or organization having proper also an insured, but only with respect to liability
temporary custody of your property if you arising out of the operation of the equipment, and
die, but only: only if no other insurance of any kind is available
(1) With respect to liability arising out of the to that person or organization for this liability.
maintenance or use of that property; and However, no person or organization is an insured
(2) Until your legal representative has with respect to:
been appointed. a. "Bodily injury" to a co-"employee" of the
d. Legal Representative If You Die person driving the equipment; or
Your legal representative if you die, but b. "Property damage" to property owned by,
only with respect to duties as such. That rented to, in the charge of or occupied by
representative will have all your rights and you or the employer of any person who is
duties under this insurance. an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that
yours which is a legally incorporated entity is less than 51 feet long and is not being used
of which you own a financial interest of to carry persons for a charge, any person is an
more than 50% of the voting stock on the insured while operating such watercraft with
effective date of this Coverage Part. your permission. Any other person or
The insurance afforded herein for any organization responsible for the conduct of
subsidiary not shown in the Declarations such person is also an insured, but only with
as a named insured does not apply to respect to liability arising out of the operation
injury or damage with respect to which an of the watercraft, and only if no other
insured under this insurance is also an insurance of any kind is available to that
insured under another policy or would be person or organization for this liability.
an insured under such policy but for its However, no person or organization is an
termination or upon the exhaustion of its insured with respect to:
limits of insurance. a. "Bodily injury" to a co-"employee" of the
3. Newly Acquired Or Formed Organization person operating the watercraft; or
Any organization you newly acquire or form, b. "Property damage" to property owned by,
other than a partnership, joint venture or rented to, in the charge of or occupied by
limited liability company, and over which you you or the employer of any person who is .
maintain financial interest of more than 50% of an insured under this provision.
the voting stock, will qualify as a Named 6. Additional Insureds When Required By
Insured if there is no other similar insurance Written Contract, Written Agreement Or
available to that organization. However: Permit
a. Coverage under this provision is afforded The person(s) or organization(s) identified in
only until the 180th day after you acquire Paragraphs a. through f. below are additional
or form the organization or the end of the insureds when you have agreed, in a written
policy period, whichever is earlier; and
Form SS 00 08 04 05 Page 11 of 24
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (e) Any failure to make such
permit issued by a state or political inspections, adjustments, tests or
subdivision, that such person or organization servicing as the vendor has
be added as an additional insured on your agreed to make or normally
policy, provided the injury or damage occurs undertakes to make in the usual
subsequent to the execution of the contract or course of business, in connection
agreement, or the issuance of the permit. with the distribution or sale of the
A person or organization is an additional products;
insured under this provision only for that (f) Demonstration, installation,
period of time required by the contract, servicing or repair operations,
agreement or permit. except such operations performed
at the
However, no such person or organization is an vendors premises in
additional insured under this provision if such connection with the sale of the
person or organization is included as an product;
additional insured by an endorsement issued (g) Products which, after distribution
by us and made a part of this Coverage Part, or sale by you, have been labeled
including all persons or organizations added or relabeled or used as a
as additional insureds under the specific container, part or ingredient of any
additional insured coverage grants in Section other thing or substance by or for
F. -Optional Additional Insured Coverages. the vendor; or
a. Vendors (h) "Bodily injury" or "property
Any person(s) or o ganization(s) (referred to damage" arising out of the sole
below as vendor), but only with respect to negligence of the vendor for its
"bodily injury" or "property damage" arising own acts or omissions or those of
out of "your products" which are distributed its employees or anyone else
However, this
or sold in the regular course of the vendors exclusion its does not behalf. apply to:
business and only it this Coverage Part
provides coverage for 'bodily injury" or (1) The exceptions contained in
"property damage" included within the Subparagraphs (d) or (f); or
"products-completed operations hazard". (fi) Such inspections, adjustments,
(1) The insurance afforded to the vendor tests or servicing as the vendor
is subject to the following additional has agreed to make or normally
exclusions: undertakes to make in the usual
course of
This insurance does not apply to: business, in
connection with the distribution
(a) "Bodily injury" or "property or sale of the products.
damage" for which the vendor is
obligated to pay damages by (2) This insurance does not apply to any
reason of the assumption of insured person organization from
liability in a contract or agreement. whom you have acquired such products,
This exclusion does not apply to or any ingredient, part container,
that the entering into, accompanying or
liability for damages
vendor would have in the absence containing such products.
of the contract or agreement; b. Lessors Of Equipment
(b) Any express warranty (1) Any person or organization from
unauthorized by you; whom you lease equipment; but only
(c) Any physical or chemical change with respect to their liability for "bodily
inj
in the product made intentionally injury", "property damage" or
by the vendor; "personal and advertising injury"
caused, in whole or in part, by your
(d) Repackaging, except when maintenance, operation or use of
unpacked solely for the purpose of equipment leased to you by such
inspection, demonstration, testing, person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the insurance afforded e. Permits Issued By State Or Political
to these additional insureds, this Subdivisions
insurance does not apply to any (1) Any state or political subdivision, but
"occurrence" which takes place after only with respect to operations _
you cease to lease that equipment. performed by you or on your behalf for
c. Lessors Of Land Or Premises which the state or political subdivision
(1) Any person or organization from has issued a permit.
whom you lease land or premises, but (2) With respect to the insurance afforded
only with respect to liability arising out to these additional insureds, this
of the ownership, maintenance or use insurance does not apply to:
of that part of the land or premises (a) "Bodily injury",
leased to you. or "personal l "Property damage"
and advertising
(2) With respect to the insurance afforded injury" arising out of operations
to these additional insureds, this performed for the state or
insurance does not apply to: municipality; or
(a) Any "occurrence" which takes (b) "Bodily injury" or 'property damage"
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises; or f. Any Other Party
(b) Structural alterations, new (1) Any other person or organization who
construction or demolition is not an insured under Paragraphs a.
operations performed by or on through e. above, but only with
behalf of such person or respect to liability for "bodily injury",
organization. "property damage" or "personal and
d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or
(1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or
only with respect to liability for "bodily the acts or omissions of those acting
injury", "property damage" or "personal on your behalf:
and advertising injury" caused, in whole (a) In the performance of your
or in part, by your acts or omissions or ongoing operations;
the acts or omissions of those acting on (b) In connection with your premises
your behalf: owned by or rented to you; or
(a) In connection with your premises; (c) In connection with "your work" and
or included within the "products-
(b) In the performance of your completed operations hazard", but
ongoing operations performed by only if
you or on your behalf.
(I) The written contract or written
(2) With respect to the insurance afforded agreement requires you to
to these additional insureds, the provide such coverage to
following additional exclusion applies: such additional insured; and
This insurance does not apply to (if) This Coverage Part provides
"bodily injury", "property damage" or coverage for "bodily injury" or
"personal and advertising injury" "property damage" included
arising out of the rendering of or the within the "products-
failure to render any professional completed operations hazard".
services by or for you, including: (2) With respect to the insurance afforded
(a) The preparing, approving, or to these additional insureds, this
failure to prepare or approve, insurance does not apply to:
maps, shop drawings, opinions, "Bodily injury", "property damage" or
reports, surveys, field orders, personal and advertising injury"
change orders, designs or arising out of the rendering of, or the
drawings and specifications; or failure to render, any professional
(b) Supervisory, inspection, architectural, engineering or surveying
architectural or engineering services, including:
activities.
Form SS 00 08 04 05 Page 13 of 24
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or This General Aggregate limit does not
failure to prepare or approve, apply to "property damage" to premises
maps, shop drawings, opinions, while rented to you or temporarily
reports, surveys, field orders, occupied by you with permission of the
change orders, designs or owner, arising out of fire, lightning or
drawings and specifications; or explosion.
(b) Supervisory, inspection, 3. Each Occurrence Limit
architectural or engineering Subject to 2.a. or 2.b above, whichever
activities. applies, the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all "bodily injury",
insureds are described in Section D. - Limits property damage" and medical expenses
Of Insurance. arising out of any one "occurrence" is the
How this insurance applies when other Liability and Medical Expenses Limit shown in
insurance is available to an additional insured the Declarations.
is described in the Other Insurance Condition The most we will pay for all medical expenses
in Section E. - Liability And Medical Expenses because of "bodily injury" sustained by any
General Conditions. one person is the Medical Expenses Limit
No person or organization is an insured with shown in the Declarations.
respect to the conduct of any current or past 4. Personal And Advertising Injury Limit
partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for
company that is not shown as a Named Insured in the sum of all damages because of all
the Declarations. "personal and advertising injury" sustained by
D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal
LIMITS OF INSURANCE and Advertising Injury Limit shown in the
Declarations.
1. The Most We Will Pay
5. Damage To Premises Rented To You Limit
The Limits of Insurance shown in the
Declarations and the rules below fix the most The Damage To Premises Rented To You
we will pay regardless of the number of: Limit is the most we will pay under Business
Liability Coverage for damages because of
a. Insureds; "property damage" to any one premises, while
b. Claims made or "suits" brought; or rented to you, or in the case of damage by fire,
c. Persons or organizations making claims or lightning or explosion, while rented to you or
bringing "suits". temporarily occupied by you with permission of
2. Aggregate Limits the owner.
The most we will pay for: In the case of damage by fire, lightning or
explosion, the Damage to Premises Rented To
a. Damages because of "bodily injury" and You Limit applies to all damage proximately
"property damage" included in the caused by the same event, whether such
"products-completed operations hazard" is damage results from fire, lightning or explosion
the Products-Completed Operations or any combination of these.
Aggregate Limit shown in the
Declarations 6. How Limits Apply To Additional Insureds
.
b. Damages because of all other "bodily The most we will pay on behalf of a person or
injury", "property damage" or "personal organization who is an additional insured
and advertising injury", including medical under this Coverage Part is the lesser of:
expenses, is the General Aggregate Limit a. The limits of insurance specified in a
shown in the Declarations. written contract, written agreement or
This General Aggregate Limit applies permit issued by a state or political
separately to each of your "locations" subdivision; or
owned by or rented to you. b. The Limits of Insurance shown in the
"Location" means premises involving the Declarations.
same or connecting lots, or premises Such amount shall be a part of and not in
whose connection is interrupted only by a addition to the Limits of Insurance shown in
street, roadway or right-of-way of a the Declarations and described in this Section.
railroad.
Page 14 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance under this (1) Immediately send us copies of any
policy and any endorsements attached thereto demands, notices, summonses or
applies to any claim or "suit", the most we will pay legal papers received in connection
under this policy and the endorsements is the with the claim or "suit"; _
single highest limit of liability of all coverages (2) Authorize us to obtain records and
applicable to such claim or "suit". However, this other information;
paragraph does not apply to the Medical Expenses
limit set forth in Paragraph 3. above. (3) Cooperate with us in the investigation,
settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply against the "suit"; and
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting (4) Assist us, upon our request, i the
with the beginning of the policy period shown in the enforcement of any right against t any
Declarations, unless the policy period is extended person or organization that may be
liable
after issuance for an additional period of less than 12 or damage which this insurance
months. In that case, the additional period will be may also apply.
deemed part of the last preceding period for purposes
of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own
GENERAL CONDITIONS cost, voluntarily make a payment, assume
any obligation, or incur any expense, other
1. Bankruptcy than for first aid, without our consent.
Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance
the insured's estate will not relieve us of our If we cover a claim or "suit" under this
obligations under this Coverage Part. Coverage Part that may also be covered
2. Duties In The Event Of Occurrence, by other insurance available to an
Offense, Claim Or Suit additional insured, such additional insured
a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the
other insurer for defense and indemnity.
You or any additional insured must see to However, this provision does not apply to
that are notified soon as the extent that you have agreed in a
practicable e of an "occurrence" or an
offense which may result in a claim. To written contract, written agreement or
the extent possible, notice should include: permit that this insurance is primary and
non-contributory with the additional
(1) How, when and where the "occurrence" insured's own insurance.
or offense took place;
f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any Claim Or Suit
injured persons and witnesses; and Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury any additional insured only when such
or damage arising out of the "occurrence", offense, claim or "suit" is
"occurrence" or offense. known to:
b. Notice Of Claim
(1) You or any additional insured that is
If a claim is made or "suit" is brought an individual;
against any insured, you or any additional
insured must: (2) Any partner, if you or an additional
insured is a partnership;
(1) Immediately record the specifics of the (3) Any manager, if you or an additional
claim or "suit" and the date received; insured is a limited liability company;
and
(4) Any "executive officer" or insurance
(2) Notify us as soon as practicable. manager, if you or an additional
You or any additional insured must see to insured is a corporation;
it that we receive a written notice of the (5) Any trustee, if you or an additional
claim or "suit" as soon as practicable. insured is a trust; or
c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you
Insured or an additional insured is a political
You and any other involved insured must: subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph I. applies separately to (3) We have issued this policy in reliance
you and any additional insured. upon your representations.
3. Financial Responsibility Laws b. Unintentional Failure To Disclose
a. When this policy is certified as proof of Hazards
financial responsibility for the future under If unintentionally you should fail to disclose
the provisions of any motor vehicle all hazards relating to the conduct of your
financial responsibility law, the insurance business at the inception date of this
provided by the policy for "bodily injury" Coverage Part, we shall not deny any
liability and "property damage" liability will coverage under this Coverage Part
comply with the provisions of the law to because of such failure.
the extent of the coverage and limits of 7, Other Insurance
insurance required by that law.
If other valid and collectible insurance is
b. With respect to "mobile equipment" to available for a loss we cover under this
which this insurance applies, we will Coverage Part, our obligations are limited as
provide any liability, uninsured motorists,
follows:
underinsured motorists, no-fault or other
coverage required by any motor vehicle a. Primary Insurance
law. We will provide the required limits for This insurance is primary except when b.
those coverages. below applies. If other insurance is also
4. Legal Action Against Us primary, we will share with all that other
No person or organization has a right under insurance by the method described in c.
below.
this Coverage Form:
a. To join us as a party or otherwise bring us b. Excess Insurance
into a "suit" asking for damages from an This insurance is excess over any of the
insured; or other insurance, whether primary, excess,
b. To sue us on this Coverage Form unless contingent or on any other basis:
all of its terms have been fully complied (1) Your Work
with. That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or
on an agreed settlement or on a final judgment similar coverage for "your work";
against an insured; but we will not be liable for (2) Premises Rented To You
damages that are not payable under the terms of
this insurance or that are in excess of the That is fire, lightning or explosion
applicable limit of insurance. An agreed insurance for premises rented to you
settlement means a settlement and release of or temporarily occupied by you with
liability signed by us, the insured and the permission of the owner;
claimant or the claimant's legal representative. (3) Tenant Liability
5. Separation Of Insureds! That is insurance purchased by you to
Except with respect to the Limits of Insurance, cover your liability as a tenant for
and any rights or duties specifically assigned "property damage" to premises rented
in this policy to the first Named Insured, this to you or temporarily occupied by you
insurance applies: with permission of the owner;
a. As if each Named Insured were the only (4) Aircraft, Auto Or Watercraft
Named Insured; and If the loss arises out of the maintenance
b. Separately to each insured against whom or use of aircraft, "autos" or watercraft to
a claim is made or "suit" is brought. the extent not subject to Exclusion g. of
6. Representations SectionA. - Coverages.
(5) Property Damage To Borrowed
a. When You Accept This Policy Equipment Or Use Of Elevators
By accepting this policy, you agree: If the loss arises out of "property
(1) The statements in the Declarations damage" to borrowed equipment or
are accurate and complete; the use of elevators to the extent not
(2) Those statements are based upon subject to Exclusion k. of Section A. -
representations you made to us; and Coverages.
Page 16 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An When this insurance is excess over other
Additional Insured To Other insurance, we will pay only our share of
Insurance the amount of the loss, if any, that
That is other insurance available to exceeds the sum of:
you covering liability for damages (1) The total amount that all such other
arising out of the premises or insurance would pay for the loss in the
operations, or products and completed absence of this insurance; and
operations, for which you have been (2) The total all deductible and self-
added as an additional insured by that o insured amounts under all that other
insurance; or insurance.
(7) When You Add Others As An We will share the remaining loss, if any, with
Additional Insured To This any other insurance that is not described in
Insurance this Excess Insurance provision and was not
That is other insurance available to an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown in the
However, the following provisions Declarations of this Coverage Part.
apply to other insurance available to c. Method Of Sharing
any person or organization who is an If all the other insurance permits
additional insured under this Coverage contribution by equal shares, we will follow
Part: this method also. Under this approach,
(a) Primary Insurance When each insurer contributes equal amounts
Required By Contract until it has paid its applicable limit of
This insurance is primary if you insurance or none of the loss remains,
have agreed in a written contract, whichever comes first.
written agreement or permit that If any of the other insurance does not permit
this insurance be primary. If other contribution by equal shares, we will
insurance is also primary, we will contribute by limits. Under this method, each
share with all that other insurance insurers share is based on the ratio of its
by the method described in c. applicable limit of insurance to the total
below. applicable limits of insurance of all insurers.
(b) Primary And Non-Contributory' 8. Transfer Of Rights Of Recovery Against
To, Other Insurance When Others To Us
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed in a written If the insured has rights to recover all or
contract, written agreement or part of any payment, including
permit that this insurance is Supplementary Payments, we have made
primary and non-contributory with under this Coverage Part, those rights are
the additional insured's own transferred to us. The insured must do
insurance, this insurance is nothing after loss to impair them. At our
primary and we will not seek request, the insured will bring "suit" or
contribution from that other transfer those rights to us and help us
insurance. enforce them. This condition does not
Paragraphs (a) and (b) do not apply to apply to Medical Expenses Coverage.
other insurance to which the additional
b. Waiver Of Rights Of Recovery (Waiver
insured has been added as an Of Subrogation)
additional insured.
If
When this insurance is excess, we will the insured has waived any rights of
have no duty under this Coverage Part to recovery against any person or
defend the insured against any "suit" if any organization for all or part of any payment,
other insurer has a duty to defend the including Supplementary Payments, we
have made under this Coverage Part, we
insured against that "suit". If no other also waive that right, provided the insured
insurer defends, we will undertake to do waived their rights of recovery against
so, but we will be entitled to the insured's such person or organization in a contract,
rights against all those other insurers. agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED AND
RIGHTS OF RECOVERY AGAINST OTHERS
N
°o This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
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ti
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m A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for
N LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the
WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE.
o B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the
o Loss Condition - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable.
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Forth HA 9913 01 87 Printed in U.S.A.
KIBBLE & PRENTICE A USI COMPANY
CERTIFICATE RETURN MAIL PROCESSING
P.O. BOX 5007
NOVATO, CA 94948-5007
CITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520-1814