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HomeMy WebLinkAboutInsurance Certificate: SOS Plumbing & Drain Srvcs 3.3 ,acoR°® CERTIFICATE OF LIABILITY INSURANCE 3//12/12/ D 2m0013 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 NAME. Susan Wilson, AAI, AIC Beecher Carlson Insurance Agency LLC PHONE (541) 772-1111 AIL No) (541)772-3785 707 Murphy Rd .susan.wilson@beechercarlson.com INSURE S AFFORDING COVERAGE NAIC0 Medford OR 97504 INSURERA AmeriCan Hallmark Ins Co of TX 3494 INSURED INSURERS 309 Plimbing & Drain Service Inc INSURERC: 206 South Pacific Hwy INSURERD; NSURER E Talent OR 97540 INSLIRGRF: COVERAGES CERTIFICATE NUMBER:CL1331225813 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. EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM SUOR POLICY NUMBER MMIILYEFF MWD I= Ina LTR DN Y LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea ocaurenca $ 100,000 A CLAIMSMADE a] OCCUR 4CL44337607 /11/2013 /11/2014 MED EXP Wry one person) $ 5,000 PERSONAL 4 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT: AGGREGATE LIMIT APP LIES PER PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY L LIMIT 1,000,000 A X ANY AUTO BODILY N IURY (Per person) $ ALL O`S ED SCHEDULED 4CLA4337607 /11/2013 /11/2014 BODILY INJURY(Pereccidel) $ NON-ONNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per ecadeN Undennsond motomt $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMSMADE AGGREGATE $ 1,000,000 DED 3C RETENTIONS 101000 40044337707 /11/2013 /11/2014 $ MWERSCOMPENSATION NC STATU -TORY LIM - 9TH ANDEMPLOYERTLMBILITY YIN ANY PROPRIETOR,PARTNERIE ECUTIVE E.L. EACH ACCIDENT $ OFFICERMEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ Ir". 4eevibe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCPoPTIDN OF OPERATON91 LOCATIONS I VEHICLES (Atlaetl ACORD 101, Addttlenal Remarks SSNadula, If more apaC4 Is raqulnm Re: Electric Department at 1963 Mae Street. Certificate holder included as additional insured per attached endorsement eMP97670408 where required by 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 Kari Olson ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Representative City of Ashland AUTHORIZED REPRESENTATIVE 90 N Mountain Avenue Ashland, OR 97520 S Wilson, AAI, AIC/SU ~yaL-w~ r J'riA ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005)01 The ACORD name and logo are registered marks of ACORD c. The following is added to A.2. Property Not Covered of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM: r. Property while stored or operated underground in connection with any mining operations. it. The following is added to Paragraph 2. of B. Exclusions of the CAUSES OF LOSS - SPECIAL FORM: n. We will not pay for loss or damage caused by puncture, blowout and road damage to Ores and tubes mounted on vehicles. However, we do pay for puncture, blowout or road damage caused by a specified peril. o. We will not pay for loss caused by humidity, dampness, dryness or changes In or extremes of temperature. p. We will not pay for loss caused by the weight of a load which, under the operating conditions at the time of a loss, exceeds the registered lifting capacity of any equipment or machine. q. We will not pay for loss due to theft or mysterious disappearance from any vehicle or attached container. We will pay for loss due to burglary when there are signs of forcible entry to a locked vehicle or container. e. E.7. Valuation of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM is deleted and replaced by the following: 7. Valuation We will determine the value of covered property in the event of loss or damage as follows: a. At actual cash value at the time of the loss (with a deduction for depreciation) except as provided in paragraphs b. and c. following. b. Pair or Set. The value of a lost or damaged article which Is part of a pair or set is based on a reasonable proportion of the value of the entire pair or set. The loss is not considered a total loss of the pair or set. c. Loss to Parts. The value of a lost or damaged part of an Rem that consists of several parts when h Is complete is based on the value of only the lost or damaged part or the cost to repair or replace it 2. Rental Reimbursement In the event of loss by a covered peril to covered contractors' equipment that you own, we will reimburse you for your expense to rent similar equipment while your equipment is inoperable. The most we will reimburse you for rental reimbursement expenses is $1,000. We will continue to reimburse you for the rental of equipment after the expiration date of this coverage provided the loss occurred before the expiration date. We will not reimburse you: a. If you can continue or resume your operations with similar equipment that is available to you at no additional expense to you; or b. For the rental expense of any equipment unless you make every reasonable effort to repair, replace or rebuild the inoperable equipment after the covered loss occurs. 3. With respect to this Additional Coverage, Contractors Equipment Coverage, Section D. Deductible of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM Is deleted and replaced by the following: D. Deductible We will not pay for loss or damage in any one occurrence until the amount of loss or damage exceeds $500. We will then pay the amount of loss or damage in excess of $500 up to the applicable limit of insurance. We will not reimburse you for the rental of equipment until after 72 hours have passed since the covered property was rendered inoperable. After 72 hours have passed, we will only reimburse you for the rental expense that you actually incur. The deductible of $500 does not apply to rental reimbursement expenses. General Liability Additional Coverages The following Additional Coverages are added to the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. A. Blanket Additional Insured Coverage 1. SECTION 11- WHO IS AN INSURED of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include as an insured any person or organization (referred to as Additional Insured) whom you are required to add as en Additional Insured on this policy under: a. A written contractor agreement; and b. Where a certificate of insurance showing that person or organization as an additional insured has been issued; and c. When the written contractor agreement and certificate of insurance are currently in effector becoming In effect during the tens of the policy and executed prior to the "bodily injury; "properly damage," or "personal and advertising injury." Page 14 of 18 Includes copyrighted materiel of ISO Pmpertks, Inc. and MP 97 67 04 08 American Assoc"ration of Insurance Services, Inc., used with their permissbn 2. The insurance provided to the Additional Insured is limited as follows: a. The Additional Insured is only an additional insured for: (1) "Bodily injury," "property damage," or "personal and advertising injury" caused in whole or in part by negligent acts or omissions of the Named Insured or anyone directly or indirectly employed by the Named Insured or for whose acts a Named Insured may be liable. (2) Liability arising out of your ongoing operations for the Additional Insured by or for you. A person's or organization's status as an insured under this coverage ends when your operations for that insured are completed. b. The Limits of Insurance applicable to the Additional Insured are those specified in the written contractor agreement but not more than the Limits of Insurance specified in the Declarations for this policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations for the Named Insured. 3. In addition to the other exclusions applicable to Section I, Coverages A., B. and C. of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, the insurance provided to the Additional Insured does not apply to: a. "Property damage" to: (1) Property owned, used, occupied by, loaned or rented to the Additional Insured; (2) Property in the care, custody or control of the Additional Insured or over which the Additional Insured are for any purpose exercising physical control; or (3) "Your work" performed for the Additional Ihsured. b. "Bodily injury," "property damage," or "personal and advertising injury" arising out of an architects, engineers or surveyor's rendering or failure to render any professional services for you, for the Additional Insured or for others, including, but not limited to: (1) The preparing, approving or failure to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) Supervisory, inspection or engineering services. c. 'Bodily injury' or "property damage' occurring after. (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured atthe site of the covered operations has been completed; or (2) That portion of your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 4. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, is amended to add the following subparagraph: d. Additional Insured's Other Insurance As Excess Insurance To the extent required by an Insured contract," this insurance Is primary an behalf of the Additional Insured; and any other insurance maintained by the Additional Insured is excess and not contributory with this insurance. If the Insured contract does not require this provision, then paragraph a. above will apply. B. Mobile Equipment Broadened Coverage V.121.(1) of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by the following: (1) Equipment designed primarily for. (a) Snow Removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning. Except the above provisions do not apply to self-propelled vehicles of less than 1,000 pounds gross vehicle weight which are not intended for use on a highway. C. Aggregate Limit Per Project The General Aggregate Limit under SECTION nl - LIMBS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to each of your projects away from premises owned by or rented to you. MP 97 67 04 08 Includes copyrighted rtmterial of ISO Properties, Inc. and Page 15 of 18 American Association of Insurance Services, Inc., used with theta pennlselon