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HomeMy WebLinkAboutInsurance Certificate: OBEC Consulting Engineers (3) OP ID: BH CERTIFICATE OF LIABILITY INSURANCE 0 DAT3/11D/YYYYI 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 CONTACT 800-338-1391 NAME: ACEC/MARSH PHONE FAX 701 Market St., Ste. 1100 888-621-3173 A/C No Eat : ACC No : St. Louis, MO 63101 E-mAa ADDRESS: Jeff B. Connelly PRODUCER CUSTOMER ID d:OBEC-01 INSURERS AFFORDING COVERAGE NAIC It INSURED OBEC Consulting Engineers INSURER A: Hartford Insurance Company 22357 920 Country Club Road INSURER B: Eugene, OR 97401-2231 INSURER C INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDNYYY IMMIDONYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 A X COMMERCIAL GENERAL LIABILITY 84SBWPA4035 03/20/13 03/20/14 PREMISES Ea occurrence $ 2,000,08 CLAIMS-MADE FK OCCUR MED EXP(Anyone 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 - COMP/OP AGO $ 4,000,00 1-1 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,008 00 accident) (Ea A X ANY AUTO 84UEGPF0127 03/20113 03120114 BODILY INJURY BODILY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULEDAUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNEDAUTOS $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 61000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,00 A 84XHGYH1723 03/20/13 03/20114 DEDUCTIBLE $ X RETENTION $ 10,000 $ WORK ERSCOMPENSATION X WCSTATU- DER AND LIABILITY A ANY PROPRIETOR/PARTNERIEXECUTIVE YIN 84WBGBJ0746 03120113 03120114 E.L. EACH ACCIDENT $ 1,888,80 OFFICERIMEMBER EXCLUDED? r-7 N/A (Mandatory in NN) E.L. DISEASE - EA EMPLOYE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS belay E.L. DISEASE- POLICY LIMIT $ 1,000,08 DESCRIPTION OF OPERATIONS C LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project: ARRA Project No.2007-17, Oak-Ann Street Section (Hersey Street Sidewalk Reconstruction) - City of Ashland is included as additional insured for above coverages except WC as required by written contract. CERTIFICATE HOLDER CANCELLATION CTYASHL 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. 51 WINBURN WAY ASHLAND, OR 97520 AUTHORIZED REPRESENTAT[VE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD