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HomeMy WebLinkAboutInsurance Certificate: Kogap Enterprises Inc , A` O/RO® DATE (MMmon rrr CERTIFICATE OF LIABILITY INSURANCE 3/20/2013 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 endorsements . - - PRODUCER , CONTACT Pdm Breazeale - NAME: Beecher Carlson Insurance Agency LLC PHONE..(541)494-2655 F^'t No): (541)494-2755 3256-Hillcrest Park Drive EADaDDAIRL~s,.pam.breazeale@beechercarlBon.com INSURERS AFFORDING COVERAGE NAIC N Medford OR. 97504 INSURER AAmerican States Insurance Cc 19704 INSURED INSURER BAmerican Economy Insurance Co 19690 &ogap Enterprises Inc INSURER C: . PO BOX 1608 INSURER D: INSURER E Medford OR 97501 INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 GL BA UM 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 ADDL SUER POLICY NUMBER MMIDDT EFF MMMCDY EXP LIMITS LTR IHM lam GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TEaoc ~rmnce) $ 1,000,000 A CLAIMS-MADE ❑X OCCUR R ICI6833721 /1/2013 /1/2014 PREMISES MED EXP(M ma pen~on) $ 10,000 PERSONAL &ADV INJURY 11000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS -COMPIOP AGG $ 2,000,000 POLICY X .PRO- _ X LOC. - $ JFCT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT. B X ANY AUTO - BODILY INJURY (Par person) $ - ALLOWNED SCHEDULED 2CE2290381 /1/2013 /1/2014 BODILY INJURY (Per accident) $ AUTOS AUTOS de,l) AGE $ NUTOS ED - PROPERTY HIRED AUTOS AUTOS (Per i M ' PIP-Basic $ 15,000 X UMBRELLA IJAB X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS U B CLAIMS-MADE AGGREGATE $ 10, 000, 000 DED RETENTIONS 10100 O1SD42715211 /1/2013 /1/2014 $ WORKERS COMPENSATION - WC STATU- OTH- ANDEMPLOYERS' UABILITY YIN 'Mffc E.L. EACH ACCIDENT $ ANY PROPRIETORPARTNERIEXECURVE ❑ NIA OFFICERIMEMBER EXCLUDED? (MarMator, In NH) E.L. DISEASE - EA EMPLOYE $ H yes, tlasuioe un0ar DESCRIPTION Or OPERATIONS bei. E.L DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Atl Itbnai Remama schedule, H more space is required) RE: Ashland Creek Sanitary Sewer General Liability policy includes Blanket Additional insured coverage as required by contract per form # CG8674 (12/07). This form is subject to policy terms, conditions; and exclusions. CERTIFICATE HOLDER CANCELLATION waymaam@ashland. or. us SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, It's Officers, agents & ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Pam Breazeale/PAMBREx /SraC- ACORD 25 (2010105) © 1988.2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 86 74 12 47 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: DUTY TO DEFEND or B or medical expenses under COV- ERAGE C, Paragraph a. of SECTION I - COVERAGE A and No other obligation or liability to pay sums or COVERAGE B is replaced by the following: perform acts or services is covered unless ex- a. We will pay those sums that the insured be- plicit!.y provided for under SUPPLEMENTARY comes legally obligated to pay as damages PAYMENTS - COVERAGES A AND B. because of 'bodily injury", "properly damage" or 'personal injury and advertising EMPLOYERS LIABILITY injury" :o which this insurance applies. We will have' ave the right and duty to defend the in- The last paragraph of exclusion e. of SECTION I - surad against any "suit" seeking those dam- COVERAGE A is replaced by the following: ages. Our duty to defend begins once you This exclusion does not apply to liability assumed TfON notify IV V of - a "suit' as COMMERCIAL described in GENERAL LISEC- - by the insured under an `insured contract" ex- ABILITY CONDITIONS, 2.b. However, we copt for that part of a contract or agreement that will have no duty to defend the insured indemnifies any person or organization for their against any "sutt" seeking damages for sole fiabilty. °bodily injury", `property damageor `personal injury or advertising injury" to WRONGFUL EVICTION which this insurance does not apply. We may, at our discretion, investigate any The following exclusion is added to SECTION I - "occurrence" and seive any claim or "suit" COVERAGE B: that may result. But: The wrongful eviction from, wrongful entry into, (1) The amount we will pay for damages is or invasion of the right of private occupancy of a limited as described in SECTION fit - room, dwelling or premises arising out of any: LIMITS OF INSURANCE; and (1) "property damage" to the room, dwell- (2) Our right and duty to defend ends when ing or premises; or we have used up the applicable limit of (2) "bodily injury" sustained through occu- insurance In the payment. of judgments pancy of a room,. dwelling or premises. or settlements under COVERAGES A spew Md Me Gdew bqo = mg" r.,x,,,.b d stew Q,"aou, CG 85 74 12 07 Page 1 of 3 EP tt_"rt,rt.curtVM „1[. ,.VRMJ arD :••.R• G ADDITIONAL INSURED - BY WRITTEN CON- This insurance does not apply to "today TRACT, AGREEMENT OR PERMIT, OR SCHED- injury", 'property damage", or ULE "personal and advertising injury" arising out of operations performed for the state The. following paragraph is added to SECTION II - or municipality; WHO IS AN INSURED: C. The insurance with respect to any architect, 4. Any person or organization shown in the Schad- engineer, or,surveyor added as an insured ule or for whom you are required by written con- by this endorsement does not apply to tract, agreement or permit to provide insurance "bodily. injury", "property damage'% or is an insured, subject to the following additional `personal and advertising injury" arising out provisions: of the rendering of or the failure to render any professional services by or for you, in• a. The contract, agreement or permit must be eluding: in effect during the policy period shown in the Declarations, and must have been axe- (1) The preparing, approving, or failing to cuted prior to the `bodily injury", "property prepare or approve maps, drawings. damage", or "personal and advertising opinions, reports, surveys, change or- injury" ders,'designs or specifications; and b. The person or organization added as an in- (2) Supervisory, inspection or engineering sured by this endorsement is an insured only services. to the extent you are held liable due to: d. This insurance does npt apply to "bodily (1) The ownership, maintenance or use of nju y" or "property damage" included within that part of premises you own, relit, the 'products-completed operations lease or occupy, subject to the following hazard", additional provisions: e. A person's or organization's status as an in- (a) This insurance does not apply to sured under this endorsement ends when any "occurrence" which takes place your operations for that insured are com- after you cease to be a tenant in pleted. any premises teased to or rented to f. No coverage will be provided if, in the ab- you; sence of this endorsement, no liability would (b) This insurance does not apply to be imposed by law on you. Coverage shall any structural alterations, new con- be limited to the extent of your negligence struction or demolition operations or fault according to the applicable principles performed by or on behalf of the of comparative fault. person or organization added as an g. The defanse of any claim or "suit" must be insured: tendered as soon as. practicable to all other (2) Your ongoing operations for that in- insurers which potentially provide insurance sured. whether the work is performed for such claim or 'suit by you or for you; h. The insurance provided will not exceed the (3)` The meintenance, operation or use by lesser of` you of equipment leased to you by such (1) The coverage and/or limits of this policy, person or organization, subject to the or following additional provisions: (2) The coverage and/or emits required by (a) This insurance does not apply to said coriiract, agreement or permit. any 'occurrence'' which takes place after the equipment lease expires; NON-OWNED WATERCRAFT AND NON-OWNED (b) This insurance does. not apply to AIRCRAFT LIABILITY "bodily injury' or 'property damage", arising out of the sole Exclusion 9• of SECTION I -:COVERAGE A is to- negligence of such person or or- placed by the following: ganization; y, go jily iiijury" ur 'pruperly damage" arising. (4) Permits issued by any state or political out of the ownership, maintenance, use or subdivision with respect to operations entrustment to others of any aircraft, "auto" performed by you or on your behalf, or watercraft owned or operated by or rented subject to the following additional pro- vision: Pago 2 of 5 • nrrnirv i cv r rv~•. , r.r. r.mma ,s"nnn, or loaned to any insured. Use includes oper- "Property damage' to: afion and loading or Unloading". (1) 'Property you own, rent, or occupy, in- "I his exclusion applies even it the claims eluding any costs or expenses incurred against any insured, allege negligence or by you, or any other person, organiza- other wrongdoing in the supervision, hiring, tion or entity, . for. repair,, replacement, employment, training or monitoring of othorc enhancement, restoration or mainte- by that insured, if the "occurrence" which nance of such property for any reason, caused the "bodily injury" or 'property including prevention of injury to a per- damagE" involved the ownership. mainte- son or damage to another's property: nance. use or entrustment to others of any aircraft, "auto' or watercraft that is owned (2) Premises you sell, give away or aban- or operated by or rented or loaned to any in- don, if the "property damage" arises out sured. of any part of those premises; This exclusion does not apply to: (3) Property loaned to you; (1) A watercraft while ashore on premises (4) Personal property in the care, custody you own or rent; or control of the insured; (2) A watercraft you do not own that is: (5) That particular part of real property on which you or any contractors or sub- (a) Less than 52 feet '.ong; and contractors working directly or indirectly (b) Not being used to carry persons or on your behalf are performing oper- ations, if the `property damage" arises out of those operations, or (3) Parking an "auto" on, or on the ways (6) That particular part of any property that next to, premises you own or rent, pro- vided the "auto" is not owned by or must be restored, repaired or replaced rented or loaned to you or the insured; because "your work" was incorrectly performed on it. (4) Liability assumed under any "insured contract' for the ownership, mainto- Paragraphs (1), (3) and (4) of this exclusion nance or use of aircraft or watercraft: or do not, apply to "property damage" (other than damage by fire) to premises, including (5) "Bodily injury" or "property damage" the contents of such premises, rented to arising out of: you. A separate limit of insurance applies to (a) the operation of machinery or Damage To Premises Rented To You as equipment that is attached to, or described in SECTION III - LIMITS OF part of,. a iand vehicle that would INSURANCE. Paragraph (2) of this exclu- • qualify under the definition of sion does not apply if the premises are "your "mobile equipment" if it were not work" and were never occupied, rented or subject -0 a compulsory or financial held for rental by you. responsibility_law or other motor ve- Paragraphs (3), (4), (5) and (6) of this exclu- hicle insurance law in the state sion do not apply to liability assumed under where ii is licensed or principally a sidetrack agreement. garaged: or Paragraph (6) of this exclusion does not ap- (b) the operation of any of the machin- ply to "property damage" included in the ery or equipment listed in Paragraph "prnd:jets-cxmmpleted operations hazard". f.(2) or f.(3) of the definition of "mobile equipment". Paragraph 6, of Section 111 is replaced by the follow- (6) An aircraft you do not own provided it is ing. not operated by any insured. 6. Subject to Paragraph 5, above, the Damage To Premises Rented To You Limit is the most we TENANTS' PROPERTY DAMAGE LIABILITY will pay under COVERAGE A for damages be- cause of "property damage" to any one prem- When Damage To Premises Rented To You Limit is ises,- while rented • to you, or in the case of shown In the Declarations, SECTION 1 - COVER- damage by fire, while rented to you or temporar- AGE A, exclusion J., Is replaced by the following: fly occupied by you with permission of the owner. j. Damage To Property CG 86 74 12' 07 Page 3 W 5 EP The Damage To Premises Rented To You Limit is the a. 'Bodily injury" or "property damage" ax- higher of $200,000 or the amount shown in the Dec- peCed or intended from the standpoint of the larations as Damage To Premises Recited To You insured. This exclusion does not apply to Limit. "bodily injury" or "property damage" result- ing from the use of reasonable force to pro- WHO IS AN INSURED - MANAGERS tact persons or property. The following is added to Paragraph 2.a. of SECTION INCREASED MEDICAL EXPENSE LIMIT. 11 - WHO IS AN INSURED: The medical expense limit is amended to $10,000. Paragraph (1) does not apply to.executive officers, or to managers at the supervisory level or above. KNOWLEDGE OF OCCURRENCE SUPPLEMENTARY PAYMENTS - COVERAGES A The following is added to Paragraph 2. SECTION IV AND B - BAIL BONDS - COMMERCIAL GENERAL LIABILITY CONDITIONS Duties In The Event Of Occuffence. Paragraph 1& of SUPPLEMENTARY PAYMENTS Offense, Claim Or. Suit of: COVERAGES A AND B is replaced by the follow- ing: Knowledge of an *occurrence", claim or 'suit" by b. Up to $3,0D0 for cost of bail bonds required your agent, servant or employee shall not in itself because of accidents or traffic taw violations constitute knowledge of the named insured unless an arising out of the use of'any vehicle. to which officer of the named insured has received such notice the Bodily Injury Liabli ty Coverage applies. from the a0ent, servant or employee. We do rot have to furnish these bonds. INSURED CONTRACT S AND UPPLEMENTARY PAYMENTS - COVERAGES A B - iNDEMNIT££S AND ADDITIONAL IN- {he following definition is added to SECTION V SUREDS - DEFINITIONS, Definition 9. '°nsured contract" par- UR agraph f,: Paragraph 2.f-(1) (d) of SUPPLEMENTARY PAY- (4) -that part of any contract or agree- MENTS - COVERAGES A AND B is replaced by ment that indemnifies any person the following: or organization for the !ndemnitee's (d) Cooperate with us with respect sole tort nabtUy. to coordinating other applicable OTHER INSURANCE insurance and self-insured retention available to the in- The first paragraph of Other Insurance of SECTION . demnitee; and IV - COMMERCIAL GENERAL LIABILITY CON- EMPLOYEES AS INSUREDS - HEALTH CARE DITIONS is replaced With the following: SERVICE If other valid and collectible insurance, or any seif•in- Paragraph 2.a.(1) d. of SECTION 11 - WHO IS AN sured retention, is available to the insured for a loss INSURED is deleted, unless excluded by separate we cover under COVERAGE A or B of this Coverage endorsement. Par:, our obligations are limited as follows: EXTENDED COVERAGE FOR NEWLY ACQUIRED METHOD OF SHARING ORGANIZATIONS The second paragraph of 4.c. Method of Sharing of Paragraph 3.a. of SECTION II - WHO IS AN IN- SECTION IV - COMMERCIAL GENERAL LIABIL-. SURED is replaced by the following: ITY CONDITIONS is replaced with the following: a. Coverage under this provision.. is afforded If any of the other insurance does riot permit contri- only until the'end of the policy period. buliuri by equal shares or is subject to a sett-Insured retention, we will contribute by limits. Under this EXTENDED "PROPERTY DAMAGE" method, each insurer's share is based on the ratio of its applicable limit of insurance or self-insured re- Exclusion a. of SECTION i - COVERAGE A is tention or both combined to the total applicable limits amended to read: Page 4 e. 5 of insurance of all insurers and the amount of any our right to collect additional premium or exercise our self-insured reteniion. right of cancellation or non-renewal. UNINTENTIONAL FAILURE TO DISCLOSE ALL LIBERALIZATION CLAUSE HAZARDS The following paragraph is added to SECTION IV - The following is added to Paragraph 6. Representa- COMMERCIAL GENERAL LIABILITY CONDI lions of SECTION. IV.- COMMERCIAL GENERAL TIONS: LIABILITY CONDITIONS: 10. If a revision to this Covorago Part, which would If you unintentionally fail to disclose any hazards ex- provide more coverage with no additional istlng at the Inception date of your policy, we wit: not premium, becomes effective during the policy deny coverage under this Crvernoa Form herauca of period in the state shown in the Declarations. such failure. However, this provision does not affect your policy will automatically provide this addi- tional coverage on the effective date of the re- vision. CG 86 74 12 07 Page 5 of 5 EP