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HomeMy WebLinkAboutInsurance Certificate: Vitus Construction Inc i-MIN VITUS-1 OP ID: RK '4~~ ° CERTIFICATE OF LIABILITY INSURANCE 0 DATE (MMIDDI'YYYY) 06118/13 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(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 503-224-2500 CONTACT Anchor Insurance & Surety, Inc 503-224-9830 PHONE FAX 1201 SW 12th Ave., Suite 500 AD Ne Exl : AIC No Portland, OR 97205-2030 E-MAIL Brent Olson ADDRESS: INSURER S AFFORDING COVERAGE NAIC 11 INSURER A: Bituminous Casual Corp INSURED VITUS CONSTRUCTION INC. INSURER B:SAIFCorporation 36196 PO BOX 1097 INSURER C: GOLD HILL, OR 97525 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 POLICY NUMBER MMDOmYY MM/DDYUP UNITS LTR GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 A X COMMERCIALGENERALLUUNLITY X CLP3588695 06118/13 06118114 PRA MISES Ea occummos $ 100,00 CLAIMS-MADE FxIOCCUR MED UP (Any one person) $ 5,00 PERSONAL B ADV INJURY E 11000,000 GENERALAGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC $ JFCT POMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident A ANY AUTO X CAP3588696 06/18113 06118114 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS X AUTOS Per accident E UMBRELLA LUIB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION X WC STIMIT ER AND EMPLOYERS' LIABILITY MIT B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N N/A 811648 10/01/12 10/01113 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED'/ (Mandatory In NH) E. L. DISEASE- EAEMPLOYEE$ 1,000,000 _-J(yyes, d scribe under - - DESCRIPTIONOFOPERATIONS below E. L. DISEASE-POLICY LIMB E 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required) 2013 Miscellaneous Concrete Project (2011-33) The City of Ashland, its officers, agents and employees are named as additional insured under general liability for both on going and completed operations and as additional insured under auto liability as per provisions of attached endorsements. CERTIFICATE HOLDER CANCELLATION ASHLA-1 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 EAST MAIN ST. ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD