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HomeMy WebLinkAboutInsurance Certificate: Portland Engineering A` °RO® CERTIFICATE OF LIABILITY INSURANCE 6/DATE (MMIDDIYYY 26/20 3 Y) 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 CONTACT Kim Schnetzky Ward Insurance Agency PHONE (591) 687-1117 aC Not' (541) 342-8280 PO Box 10167 E-MAIL .kim@wardinsurance. net INSURERS AFFORDING COVERAGE NAIC N Eugene OR 97440 INSURER A-Cincinnati Specialty 13037 INSURED INSURER B:Continental Casualty Company Portland Engineering, Inc. INSURER C: 7675 High Banks Road Suite 1 INSURER D: INSURER E Central Point OR 97502 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/AL/UMB/PROF LIAR 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 ADDL UB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYNNY MMIDD/YYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE REN D PREMISES Eaoccurtence E 100,000 A CLAIMS-MADE FxIOCCUR X S00039055 /1/2013 /1/2014 MED EXP(Any one person) $ Exclude X $1,000 BI/PD DED PERSONAL B ADV INJURY $ 1,000,000 PER OCCURRENCE A STOP GAP LIABILITY GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. $1,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED I SINGLE LIMIT E R 1,000,000 A ANY AUTO BODILY INJURY (Per Person) S ALL OWNED SCHEDULED SU0039055 /1/2013 /1/2014 BODILY INJURY (Per accident) $ AUTOS AUTOS I HIRED AUTOS AUTOS E X UMBRELLA LIAR X OCCUR RRENCE $ 2,000,000 X X NON-OWNED AE.L.~CHACCIDENT AMAGE $ A EXCESS LIAR CLAIMS-MADE $ 2,000,000 DED RETENTIONE SU0039058 /1/2013 /1/2014 $ WORKERS COMPENSATION TD OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRU TOR/PARTNER/EXECUT IVE OFFICERIMEMBER EXCLUDED? N/A CIDENT E (Mandatory in NH) - EA EMPLOVF_ $ If yes, deamod, under - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B PROFESSIONAL LIABILITY 6 CH288379629 /1/2013 /1/2014 LIMIT $1,000,000 POLLUTION LIABILITY DEDUCTIBLE $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 181, Additional Remarks Schedule, H more space is required) Re: WWTP Wonderware Modernization City of Ashland is named as additional insured as respects to work performed by the named insured under written contract agreement and per attached CSIA405-A. Completed operations apply per attached CSIA405-A. Coverage is primary 6 non-contributory per attached CSIA405-A. Waiver of subrogation is applicable per attached CSIA405-B. 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. 1295 Oak St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE M Holcomb/TRACEE ACORD 25 (2010/05) © 1988.2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - OPERATIONS AND COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITYCOVERAGE PART A. :Section 11 - Who is an Insured is dated (wrap-up) insurance program has amended to include as an additional insured been provided by the prime contrac- any person or organization when you and for/project manager or owner of the con-- such person or organization have agreed in struction project in which you are in- writing in a contract or agreement that such volved. person or organization be added. as an addi- tional insured on. your policy, but, only to the 3. 'Bodily injury", "property damage" or "per extent that the liability is caused by 'Your sonal and advertising injury" to any em- work' performed for that additional insured ployee of you or to any obligation of the and only to the extent that such livability is additional insured to indemnity another caused by your negligence,. acts or omissions because of damages arising out.of. such or the negligence, acts or omissions of those injury. acting on your behalf. 4. "Bodily in1a roPerty. damage" or *r- If "property. If not specified otherwise in the written con- sonar and advertising injury" for which the tract or agreement, a person's or organizer- Named Insured is afforded no coverage tion's status as an additional insured under under this policy of insurance. this endorsement. ends one year after your C. With respect to the.insurance afforded to operations for that additional insured are com- these additional insureds, SECTION III - LIM- pleted. The written contract or agreement ITS OF INSURANCE is amended to include: must be currently in.effect or become effective during the term of this Coverage Part. The The. limits applicable to the additional insured: contract or agreement must be executed prior are those specified in the written contract or to the "bodily injury"; `property damage" or agreement or in the Declarations of'this Cov- "personal and advertising injury" to which this erage Part, whichever is less. If no limits are endorsement pertains. specified in.the written contractor agreement, the limits applicable to the additional insured B. With respect to the insurance afforded to are those specified in the Declarations of this these additional insureds; the following addi- Coverage Part. The limits of insurance are.:in- tional exclusions apply: elusive of and not in addition to the limits of This insurance does not apply to: insurance shown in the Declarations. 1. "Bodily injury" "property damage" or D, With respect to. the insurance afforded to "personal and advertising injury arising these additional Insureds, SECTION IV - out of the rendering of, or the failure to COMMERCIAL GENERAL LIABILITY CON- render, any professional architectural, en- DITIONS, 4. Other Insurance' is amended to gineering or surveying services, including: include: a. The preparing, approving, or failing to. Any. coverage provided herein will be excess prepare or approve, maps, shop over any other valid and collectible insurance drawings, opinions, reports, surveys; available to the additional insured whether field orders, change orders or draw- primary, excess,. contingent or on any other ings and specifications, or basis unless you have agreed in a written con- b. Supervisory,. inspection, architectural tract or written agreement executed prior to or engineering activities. any loss that this insurance will be primary. 2. "Bodily In u or "property damage' aris- This insurance will be noncontributory only if Ind out . of 1 "your work" for which a 'consoli- you have so agreed in a written contract or Includes copyrighted material of Insurance CISIA405 (08/09)-A Services Office, Ind., with its permission. Paige l of 2 written agreement executed prior to any loss and this coverage is determined to be primary. Includes copyrighted material of Insurance CSIA405 (08/09)-A Services Office, Inc., with its permission. page2 of .2 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. Includes copyrighted material of ISO Properties, Inc., with its permission. CSIA405 (08109)-B Page 1 of 1