Loading...
HomeMy WebLinkAboutInsurance Certificate: JBR Environmental Consultants JBRC010 OP ID: JN A~O~RD" CERTIFICATE OF LIABILITY INSURANCE 0 DATE 1 08/06/13 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 801-486-1373 CONTACT NAME, HONE FAX Olympus Insurance Agency 801 X85-6943 P PO BOX 65608 NC No EMI, IC No)- Salt Lake City, UT 84165-0608 AE-MAIL DDRESS: F. David Child, Jr. INSURER(S) AFFORDING COVERAGE NAIC M INSURER A: American Economy Insurance Co INSURED JBR Envrmmntl. Consultants Inc INSURER B: Homeland Insurance Co. of NY 8160 South Highland Drive A-4 INSURERC: Sandy, UT 84093 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 MMIODNYYY MIDDIYYYY LIMITS JM M1 LTR GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 B X COMMERCIAL GENERAL LIABILITY X X 793000210 0002 06104/13 06/04/14 PREMISES Ea occunence $ 50,08 CLAIMS-MADE a OCCUR MED EXP (Any one person) $ 5,00 B X Pollution Liab 793000210 0002 08/04/13 06/04/14 PERSONAL BADV INJURY $ 2,000,00 B X Prof Liab Clms Mot 793000210 0002 06/04/13 08/04/14 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 2,000,00 POLICY X PRO LOG $ AUTOMOBILE LIABILITY CEaOMBINED SINGLE LIMIT cci 1,000,00 adent A X ANY AUTO 02CE223524 08/04/13 08/04/14 BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIMB OCCUR EACH OCCURRENCE $ EXCESS UAS CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- ANDEMPLOYERS'LIABILfTY YIN ANY PROPRIETORMARTNERIEXECUTIVE ❑ NIA E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes. describe under DESCRIPTION OF OPERATIONS bei. E.L. DISEASE - POLICY LIMIT S A Inland Marine 02CE223624 08/04113 08104114 Rented Eq 100,00 A Property 02CE223524 08104113 08104/14 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ABach ACORD 101, Additional Remarks Schedule, If more space Is required) The City of Ashland, OR and its elected officials, officers and employees are listed as additional insured as per written contract. Insurance is primary 6 non-contributory as per written contract. Waiver of subrogation applies as per written contract. The agency agrees to give 30 days written notice in the event of cancellation. 10 days notice for non-pay cancellation CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main Street Ashland, OR 97520 AUTHORIZED REPRESENT E • F. David Child, air a a ©1988-2010 ACORD CORPORATION. All righ served. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD JBRC010 OF ID: JN SRO CERTIFICATE OF LIABILITY INSURANCE 0 DATE 1 08/06/13 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 801-486-1373 CONTACT NAME: Olympus Insurance Agency 801 ASS-6943 PHONE FAX PO So, 65608 A/c No ac No : Salt Lake City, UT 84165-0608 AE-NIAIL DDRESS: F. David Child, Jr. INSURERS AFFORDING COVERAGE NAIL 0 INSURER A: American Economy Insurance Co INSURED JBR Envrmmntl. Consultants Inc INSURER a: Homeland Insurance Co. of NY 8160 South Highland Drive A-4 Sandy, UT 84093 NSURERC: 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 A OL UB TR TYPE OF INSURANCE POLICY NUMBER MMIDO/YYYY MNVDD[YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 _ffAIV[TUET0 RENTED B X COMMERCIAL GENERAL LIABILITY X 793000210 0002 06/04113 08/04114 PREMISES E. occunence $ 50,00 CLAIMS-MADE Fx_]OCCUR MED EXP (Any one person) $ 5,00 B X Pollution Liab 7930002100002 08/04/13 06/04114 PERSONAL B ADV INJURY $ 2,000,00 B X Prof Liab Clms Md 793000210 0002 08/04/13 08104114 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY X PRO- LOC $ IFCT AUTOMOBILE LIABILITY COMBINED t SINGLE LIMIT $ 1,000,00 A X ANY AUTO 02CE223524 08104/13 06104/14 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA /JAB OCCUR EACH OCCURRENCE $ EXCESS DAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH-TORY LIMITS FR ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? _ (Mandatary in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Inland Marine 02CE223524 08/04113 08/04114 Rented Eq 100,00 A Property 02CE223524 08/04/13 08104114 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requited) The City of Ashland, Oregon, and its elected officials, officers and employees are listed as additional Insureds. The insured General Liability Policy is primary and non-contributory to The City of Ashland, Oregon, and its elected officials, officers and employees. The agency agrees to provide 30 days written notice in the event of cancellation. 10 days written notice CERTIFICATE HOLDER CANCELLATION ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESEN go 9 F. David Child, J 44""11 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORQ name and logo are registered marks of ACORD NOTEPAD. HOLDER CODE ASHLAND JBRC010 PAGE2 INSURED'SNAME JBR Envrmmntl. Consultants Inc OP ID: JN DATE 08/06/13 for non-payment cancellation.