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HomeMy WebLinkAboutInsurance Certificate: Beecher Carlson " ',aco CERTIFICATE OF LIABILITY INSURANCE 3//8/28/2 p/01133 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 pollcy(les) 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 NCONTACT AME' Judith L. BOlch Beecher Carlson Insurance Services, LLC PHONE rt (678)539-4800 A/~Na:(678)539ia90 six Concourse Parkway noo.~Ess E:]boich@beechercarlson.com Suite 2300 PRODUCER 0,00011538 CUSTOMER Atlanta GA 30328 INSURERS) AFFORDING COVERAGE NAICas INSURED INSURER A: Zurich Atnerican Ins. Co. 6535 INSURER B'. Beecher Carlson Holdings Inc INSURER C: six Concourse Parkway INSURER D' Suite 2300 INSURER E' Atlanta GA 30326 INSURERF' COVERAGES CERTIFICATE NUMBER:12.13 All Liab 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFF POLICY XP INSR TYPE OF INSURANCE - SUER LTR POLICY NUMBER MM/pDM'YY MM/ODIYYVY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurrence) $ 1,000,000 A CLAIMS-MADE aOCCUR PO5477096-02 /17/2012 7/17/2013 MEDEXP(Anyooeperson) $ 10,000 PERSONAL B ADV INXRY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIESPER PRODUCTS - COMP)OP AGG $ Included X POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY i COMBINED SINGLE LMIT ANY AUTO (Ea aoadenn f 1,000,000 P05477096-02 BODILY IN.RIRY (Per person) $ A ALL ORNED AUTOS /17/2012 i /17/2013 BODR Y IN.UPY(Per coaden0 f SCHEOULEDAUT03 PROPERTY DAMAGE X HIRED AUTOS (Per ocedenll $ X NOWOMED AUTOS Hired A Nonowned Arse $ Hired Collision $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 8 10,000,000 EXCESS LIAR CLAIMS-MADE i AGGREGATE $ 10,000,000 DEWCTIBLE JC547709803 /17/2012 I 1(!/17/2013 $ A RETENTION $ S VYORKERS COMPENSATION 1U OETR H-1 A AND EMPLOYERS'LIABILITY VIN X TOVLIY S I- ANY PROPRIETORrPARTNEMID(ECUTIVE E L EACH ACCIDENT S 1,000,000 OFFICERIMEMBER EXCLUDI NIA (Mandatory In NH) 5477097-02 /17/2012 ((7/17/2013 EL 05EASE EA EMPLOYE 8 1 000 000 It S. deserts under j DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ 1.00o.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, 11 mom space is required) The City of Ashland, Oregon and its elected officials, officers and employees are included as additional insured as respects general liability coverage on a primary basis, but only with respect to Consultant Services to be provided under written contract. This form is subject to policy terms, conditions, and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Hari Olson, Purchasing Representative AUTHORIZED REPRESENTATIVE 90 N Mountain Avenue Ashland, OR 97520 n Robert Hesse(/JSOICH ACORD 25 (2009109) OO 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CPO 5477096-02 COMMERCIAL GENERAL LIABILITY Effective Date 07/17/2012 - 07/17/2013 CG 20 15 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. ADDITIONAL INSURED -VENDORS This endorsement modlfles Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anaation s Vendor Your Products AN'i PERSON OR ORGANTZATT,- WITH WHOM YOU HAVE A-GREEL Ti RCUGF S9,%TTTEP7 CONTFA,CT, . A.CREEMENT OR PETZ-14TT, EXECUTED PRIOR TO THE LOSS, TC PRC`VIDE Al)DTTICNAL T11SUR E :TI3Rr. ;a. Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section II - Who Is An Insured is amended to c. Any physical or chemical change in the include as an additional insured any person(s) or product made intentionally by the vendor; organization(s) (referred to below as vendor) d. Repackaging, except when unpacked solely shown in the Schedule, but only with respect to for the purpose of inspection, demonstra- "bodily Injury" or 'property damage" arising out of tion, testing, or the substitution of parts 'your products" Shown in the Schedule which are under instructions from the manufacturer, distributed or sold in the regular course of the and then repackaged in the original con- vendor's business, subject to the following addi- tamer; tional exclusions: 1. The insurance afforded the vendor does not e. Any failure to make such inspections, ad- apply to: jusiments, tests or servicing as the vendor has agreed to make or normally undertakes a. "Bodily injury" or "property damage" for to make in the usual course of business, in which the vendor is obligated to pay dam- connection with the distribution or sale of ages by reason of the assumption of liability the products; in a contract or agreement. This exclusion f. Demonstration, installation, servicing or does not apply to liability for damages that repair operations, except such operations the vendor would have in the absence of performed at the vendor's premises in con- the contract or agreement; nection with the sale of the product; b. Any express warranty unauthorized by you, CG 20 15 0704 © ISO Properties, Inc., 2004 Page 1 of 2 ❑ yen, copy