Loading...
HomeMy WebLinkAboutInsurance Certificate: Thornton Engineering 1 , 9THOREN OP ID: JS ACORO' DATE (MMIOD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/13/13 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 endorsement(s). PRODUCER _ 541-779-4232 CONTACT NAME: Hart Insurance 541-772.3963 PHONE FAX 1123 Royal Ave. NC, No Es : A/o No Medford, OR 97504 E-MAIL - Hart Insurance/ Medford ADDRESS: INSURERS AFFORDING COVERAGE NAIC d INSURER A: Mutual of Enumclaw 14761 INSURED Thornton Engineering Inc INSURER B: Travelers Casual & Surety PO BOX 476 INSURER C Jacksonville, OR 97530 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 TYPE OF INSURANCE 5UBH POLICY NUMBER MMIJ Y EFF MPMMCOYnUP, LIMn3 INSR LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,08 A X COMMERCIAL GENERAL LIABILITY X CPP000633902 07/01/13 07/01/14 PREMISES Ee odcunence $ 300,08 CLAIMS-MADE 111 OCCUR MED UP (My one person) S 10,08 B X Professional E&O 105350491 10/01/11 10101113 PERSONAL &ADV INJURY $ 1,000,08 GENERAL AGGREGATE $ 2,080,08 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGO S 2,000,08 X POLICY PRO LOC Prof E&O $ 1,000,00 .11 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,888,88 Ea accident A X ANY AUTO COP000633902 07/01113 07101/14 BODILY INJURY (Per Person) S ALL OWNED SCHEDULED BODILY INJURY (Per eoddant) $ AUTOS AUTOS NON-OWNED - PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS 1! CLAIMS-MADE AGGREGATE $ DEO RETENTIONS I $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y1 N ANY PROPRIETORIPARTNER/EXECUTNE 17 N/A E.L. EACH ACCIDENT $ OFFICERNIEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EAEMPLOYEE E If ea, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (AKach ACORD 101, AddlUonel RamarM Schedule, N mom apace Is repulred) City of Ashland, Oregon, it Is elected officials, officers and employees are included as additional insured as respects general liability per form CG3261 10/05 attached. 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. 20 E Main Street Ashland, OR 97520 aWrIn ED REPRESENTATIVE a fns ranee M r ©1988-2010 A O ORPORATION. All r hts reserved. ACORD 25 (2010/05) The ACORD name and to are re 'stored marks of AC D POLICY NUMBER: CPP000633902 COMMERCIAL GENERAL LIABILITY CG 32 61 10 05 THIS ENDOR IEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON ADDITIONAL INSURED - OWNERS, `LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Ashland 20 E Main St. Ashland, OR 97520 Location(s) Of Covered Operations: Information required to com lete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sion applies: with respect to liability for "bodily injury', "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" caused by your ongoing operations for the addi- tional insured(s) at I the location(s) designated 1. All work, including materials, parts or equip- above and only to the extent that such "bodily inju- ment furnished in connection with such work, ry", "property damage" or "personal and advertis- on the project (other than service, maintenance ing injury" is caused by your negligence or the neg- or repairs) to be performed by or on behalf of ligence of those pertorming operations on your the additional insured(s) at the location of the behalf. 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 32 61 10 05 0 ISO Properties, Inc., 2005 Page 1 of 1 ❑