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HomeMy WebLinkAboutInsurance Certificate: OBEC Consulting Engineers OP ID: BH CERTIFICATE OF LIABILITY INSURANCE 0 DAT3111OIYYYY) 03/11/13 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 800.338-1391 CONTACT ACECIMARSH 888.621-3173 PNAME: HOIL. FAX 701 Market St, Ste. 1100 AIEat c No : St. Louis, MO 63101 E-MAIL Jeff B. Connelly ADDRESS: PRODUCER DBEC-D1 CUSTOMER ID e: INSURER(S) AFFORDING COVERAGE NAIC p INSURED OBEC Consulting Engineers INSURERA:Hartford Insurance Company 22357 920 Country Club Road Eugene, OR 97401-2231 INSURERS, INSURER C INSURER D INSURER E NSURER 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 EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 2,000,00 A X COMMERCIAL GENERAL LIABILITY 84SBWPA4035 - 03120/13 03/20/14 PREMISES Ea occurrence) S 2,000,00 CLAIM&MADE Fx-l OCCUR MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 2,000,00 PROF. LIABILITY EXCLUDED GENERAL AGGREGATE $ 4,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ 4,000,00 17 POLICY X PRO- LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,00 A X ANY AUTO 84UEGPF0127 03120/13 03/20/14 (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $SCHEDULED AUTOS PROPERTY DAMAGE E HIRED AUTOS (Per accitlant) NON-OWNED AUTOS $ I is X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 1$ 5,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,00 A 84XHGYH1723 03120113 03120114 DEDUCTIBLE $ X RETENTION $ 10 OOO E WORKERS COMPENSATION X WC STATU- ! OTH. AND EMPLOYERS' LIABILITY A ANY PROPRIETORIPARTNERA2XECUTIVE YIN 84WBGBJ0746 03/20/13 03120114 E. L. EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? F-] NIA (Mandatory in NH) E.L. DISEASE. EA EMPLOYEE $ 1,000,00 I f s , describe antler DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT It 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONSI VEHICLES (Attach ACORD 101, Additional Romania Schedule, if mom space Is required) RE: Calle Guanajuato Resurfacing Project, Phase 2- The City of Ashland, Oregon and its elected officials, officers and employees are included as additional insured for above coverages except WC as required by written contract. Coverage is primarryy and non-contributory to any other insurance carried except Umbrella. (GLAI, AutOAI) CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, Ashland Parks ACCORDANCE WITH THE POLICY PROVISIONS. and Recreation Attn: Rachel Dials AUTHORIZED REPRESENTATIVE 20 East Main Street Claw Ashland. OR 97520 orv ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 84SBWPA4035 BUSINESS LIABILITY COVERAGE INSURED: OBEC Consulting Engineers ADDITIONAL INSUREDS BY CONTRACT, AGREEMENT OR PERMIT This is a summary of the Coverage provided under the following: BUSINESS LIABILITY COVERAGE FORM SS 00 08 WHO ISAN_INSURED (Section_G) states that_the following is also an additional insured:.--- Additional Insured by Contract, Agreement or Permit Any person or organization is an additional insured when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the executive of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under the provision only for that period of time required by the contract, agreement or permit. With respect to the insurance afforded to the additional insured, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specification: or (b) Supervisory, inspection, architectural or engineering activities. Primary and Non-Contributory to Other Insurance When Required by Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Rev4 OBEC Consulting Engineers 84UEGPF0127 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an "insured' for 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. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the loss Condition - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Forth HA 99 13 01 87 Printed in U.S.A.