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HomeMy WebLinkAboutInsurance Certificate: Carollo Engineers (2) DAT1 (MMIDD YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 1 212012013 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 t° 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 Risk Strategies Company CONTACT NAME: 2040 Main Street, Suite 580 PHONE NC No (AIC, No. E91, 949-242-9240 PAY Irvine, CA 92614 EWAIL ADDRESS: syounu(ddsk-aIcaI?giQa,om INSURERS AFFORDING COVERAGE NAIC IT wwwAsk-strategies.com CA DOI License No. OF06675 INSURER A: Hanover 79992 INSURED INSURER B Carollo Engineers 2700 Ygnacio Valley Road, #300 INSURERC: MassachusetaQayloatiranceCompaoy Walnut Creek CA 94598 INSURER D: CQDtl0V.Dl@IQiISUaItYCOTTDaDY 2D443 -1 ' INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 18717799 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 A14Y 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. ADDL UBR POLICYEFF POLICYEXP INER TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIODA/ LIMITS LTR A GENERAL UABILITY J ZHF8944892-03 12/31/2013 12/31/2014 EACH OCCURRENCE S $1,004000 AMA ET ENTED $1,000,000 COMMERCIAL GENERAL UABILITY REMI ES Ea oavnerKe $ CIAIMS-MADE M OCCUR MED EXP (Any one Person) S $25.000 PERSONAL& ACV INJURY S $1,000,000 GENERAL AGGREGATE $ $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. PROOl1CTS-COMPIOP AGG S $2,000,000 POLICY PRO- JECT F71 LOC f AUTOMOBILE UABIUTY Ea exiEent IN LE LIMIT $ ANY AUTO BODILY INJURY (Per person) S ALL OWNED F7 AUTOS e AUTOS DULED BODILY INJURY (Per ao: denr) E NON-0OWNED PRaO aEmtMMAGE E HIRED AUTOS AUTOS E S UMBRELLA LUIS OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS-MADE AGGREGATE $ DEO RETENTION $ $ S $ C WORKERS COMPENSATION WDF8957499-05 12131/2013 12131/2014 WC STATU- 01P- AND EMPLOYERS' LIABILITY TORY LIMITS ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ NIA E.L. EACH ACCIDENT $ $1,000,000 OFFICERIMEM H, EXCLUDED? E.L. DISEASE- EA EMPLOYEES 1000000 (Mandatory in NH, If yes, desviDe under . DISEASE - POLICY LIMIT $ $1,000,000 DESCRIPTION OF OPERATIONS below E L. D Professional Liability AEH288354410 714/2013 7/412014 Each Claim: $1,000,000 Unlimited Prior Acts Aggregate: $1,000,000 Deductible : $400,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks ScMdule, if more space is required) Operations as per Contract on file with Insured. Professional Liability is written in aggregate limits of liability not less than the amount shown. RE: Disinfection Byproduct Improvements. Project 2012-05. Carollo Project 922228A.00. City of Ashland, Oreand its elected officials, officers and employees are included as additional insureds with respects to General Liability and this policy is Primary &M-Contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORRED REPRESENTATIVE BSTN Mike Christian ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 18711'/99 (I11N) Sandi Moreno 12/20/2013 5:01:02 PM Page 1 of Architects and Engineers The following policy language is from Commercial General Liability Coverage Forms The following are mandatory fortes on the policy identified on the Certificate of Insurance: 421-0779 (09 09) CALIFORNIA COMMERCIAL GENERAL LIABILITY SPECIAL BROADENING ENDORSEMENT • Additional Insured by Contract, Agreement or Permit Under Section II Who Is An insured, Paragraph 4.is added as follow: 4a. Any person or organization with whom you agreed, because of a written contract, written agreement or permit to provide insurance is an insured, but only with respect to: 1. "Your work" for the additional insured(s) at the location designated in the contract, agreement or permit; or 2. Premises you own, rent, lease or occupy. b. This provision does not apply: 1. Unless the written contract or written agreement has been executed or permit has been issued prior to the "bodily Injur', "property damage", 'personal injury" or "advertising injury". 2. To any person or organization Included as an Insured by an endorsement Issued by us and made part of this Coverage Part. 3-. To any person or organization included as an insured under item 2 of this endorsement 4. To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily Injury", "property damage", "personal injury" or "advertising Injury" arises out of sole negligence of the lessor. 5. To Any: (a) Owners or other Interests from whom land has been leased which takes place after the lease for the land expires; or (b) Managers or lessors of premises if: I. The occurrence takes place after you cease to be a tenant in that premises; or ii. The 'bodily injur', "property damage', "personal injury' or "advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor. • Aggregate Limit Per location 1. Under Section III - Limits of Insurance the General Aggregate Limit applies separately to each of your "locations 2. Under Section V - Definitions, definition 23. is added as follow: 23. "Location" means premises involving the same or connecting lots or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. CG 2503(05 09) DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT • Aggregate Limit of Insurance (Per Project) COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Your projects away from premises owned by or rented to you A. For all sums which the Insured becomes legally obligated to pay as damages caused by "occurrences" under Section I- C Coveerage A, and for all medical expanses caused by accidents under Section 1- Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown In the Schedule above: 1. A separate designated construction project general aggregate applies to each designated construction project, and that limit is equal to the amount of the general aggregate limt shown in the declarations. 2. The designated construction project general aggregate limit is the most we will pay for the sum of all damages under Coverage A, except damages because of 'bodily injury" or 'property damage' included in the "products completed operations hazard and for medical expenses under Coverage C regardless of the number of: a. Insured's b. Claims made or "suits" brought; Or c. Persons or organizations making claims or bringing "suits". Includes copyrighted material of Insurance Services Offices, Inc., with its permission CERT NO.: 10717799 (IRW) Sandi Moreno 13/30/2013 S:D1:03 PM Page 2 of 7 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate limit for any other designated construction - project shown in the schedule above. 4. The limits shown in the Declarations for each occurrence, damage to premises rented to you and medical expense continue to apply. However, instead of being subject to the General aggregate limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section 1- Coverage A, and for all medical expenses caused by accidents under Section 1-Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project show in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate limit or the products-completed operations aggregate limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury' or "property damage' included in the products completed operations hazard will reduce the products completed operations aggregate limit, and not reduce the general aggregate limit nor the designated construction project general aggregate limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or time tables, the project will still be deemed to be the same construction project. E. The provisions of Section III-Limits of insurance not otherwise modified by this endorsement shall continue to apply as stipulated. 421-0452 (0607) OTHER INSURANCE-PRIMARY AND NON-CONTRIBUTORY (ADDITIONAL INSURED) • Additional Insured by Contract, Agreement or Permit Amended-Primary & Non-Contributory Includes copyrighted material of Insurance Services Offices, Inc., with its permission The following is added to Section IV -Commercial General Liability Conditions 4. Other Insurance a. Additional Insured's if you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an additional insured under Section II who is an insured, is primary and non-contributory, the following applies: 1. Primary Insurance This insurance is primary to other insurance that is available to the additional insured which covers the additional insured as a named insured. We will not seek contribution from any other insurance available to the additional insured except: 1. For sole negligence of the additional insured;. II. When the additional insured is an additional insured under another primary liability policy; or III. When 2. Below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in 3. Below. 2. Excess Insurance This Insurance is excess over: (1) Ally of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is fire. extended coverage, builders risk, installation risk or similar coverage for your work"; (b) That is fire insurance for premises rented to the additional insured or temporarily occupied by the additional insured with permission of the owner; - (c) That is insurance purchased by the additional insured to cover the additional Insured's liability as a tenant for "property damage" to premises rented to the additional insured or temporarily occupied by the additional with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, 'autos" or watercraft to the extent not subject to Exclusion g. of Section I - Coverage A - Bodily Injury and Property Damage Liability. When this insurance is excess, we will have no duty under coverage's A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against "suit". If no other insurer defends, we will undertake to do so, but we will be entitle to the insured's rights against all those other insurers. - When this insurance is excess over other insurance we will pay only our share of the amount of the loss, if any, that exceeds the sum of: 1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and 2) The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this excess insurance provision and was not bought specifically to apply in excess of the limits of insurance show in the declarations of this coverage part. Includes copyrighted material of Insurance Services Offices, Inc., with its permission GERT NO.: 18717799 IIRVNI Sandi Moreno 12/20/3013 5,01:02 PM Page 3 of I 3. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also under this approach each insurer contributes equal amounts until it has paid its applicable limit of Insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurers share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. CG0001 (12 07) COMMERCIAL GENERAL LIABILITY COVERAGE FORM • Separation of Insured's Except with respect to the Limits of Insurance, and any fights or duties specifically assigned in this Coverage Part to the first Named Insured, this Insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit' is brought. CG 2404 (05 09) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY TO US • Waiver of Subrogation COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERARTIONS LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Persons or organizations with whom you have a written contract executed prior to the "bodily Injury" or "property damage," that requires you to waive your rights of recovery The following is added to Paragraph B.Transfer Of Rights Of Recovery Against Others To Us of Section IV- Conditions: We waive any right of recovery we may have against the person or organization shown In the Schedule above 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 the person or organization shown in the Schedule above. - C~dl~Al~d~(~Al.ZtnnT Authorized Representative Name Insured: Carollo Engineers Policy NO. ZHF8944892-03 Additional Insured: Any person or organization with whom the named. insured agreed in a written contract to name as additional insured. ,City of Ashland, Oregon, and its elected officials, officers and employees This Notice does not form a part of the insurance contract. No coverage is provided by this Notice, nor can it be construed to replace any provisions of the policy (ncluding its endorsements). If there is any conflict between this Notice and the policy (including its endorsements), the provisions of the policy (including its endorsements) shall prevail. Includes copyrighted material of Insurance Services Offices, Inc., with its permission CERT NO.: IV17199 MANN) sands Noreno 12/20/2013 5:01:02 PM Page 4 or 7 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READIT CAREFULLY. IT IS HEREBY UNDERSTOOD AND AGREED THATTHIS POLICY SHALL NOT BE CANCELLED BY THE COMPANY WITHOUT 30 (THIRTY) DAYS WRITTEN NOTICE, TO THE ASSURED, EXCEPT THAT IN THE EVENT OF NON-PAYMENT OF PREMIUM THIS POLICY MAY BE CANCELLED WITHIN 10 (TEN) DAYS WRITTEN NOTICE. Certificate Holder: City of Ashland 20 East Main Street Ashland OR 97520 Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, agreements or limitation of the policy other than as above states. (Completion of the following, including countersignature, is required to make this endorsementeffective only when it is Issued subsequent to preparation of the Policy.) Effective 12131/2013 this endorsement forms apart of Policy No. WDF8957499-05 Issued to Carollo Engineers By Massachusetts Bay Insurance Company Dateoflssue Countersignedby Authorized Representative of the Company 331-0230 1003 Page 1 of 1 l MRT x0.: 10117799 (IkI ) Sandi loreoo 12/20/2013 5:01:02 PM Page 5 of Named Insured: Carollo Engineers Policy NO.ZHF8944892-03 NOTICE OF CANCELLATION TO DESIGNATED ENTITY(S) (Including Nonpayment of Premium) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART SCHEDULE Name of Designated Entity Mailing Address or Email Address Thirty (30) Days Notice City of Ashland 20 East Main Street Ashland OR 97520 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. If we cancel this policy for any reason, including nonpayment of premium, we will give written notice of such cancellation to the Designated Entity(s) shown in the Schedule. Such notice may be delivered or sent by any means of our choosing. The notice to the Designated Entity(s) will state the effective date of cancellation. Unless otherwise noted in the Schedule above, such notice will be provided to the Designated Entity(s) no less than the number of days In advance of the effective date of cancellation that we are required to provide to the Named Insured for such cancellation. If the reason for cancellation is nonpayment of premium, however, we will provide ten days notice. Such notice of cancellation is solely for the purpose of Informing the Designated Entity(s) of the effective date of cancellation and does notgrant, alter, or extend any rights or obligations underthis policy. ALLOTHER TERMSAND CONDITIONS OFTHIS POLICY REMAIN UNCHANGED, e t r C~ Authorized Representative or countersignature (where required by law) Includes copyrighted materials from ISO, Inc.2003 Page 1 of 1 C6RT NO.: 16717799 IIRV ) Sandi eareno 12/20/2013 5:01:02 PM Page 6 Of 7 CNA PROFESSIONAL LIABILITY AND POLLUTION For All the Commitments you Make INCIDENT LIABILITY INSURANCE POLICY INSURED: Carollo Engineers Policy AEH288354410 E f f ective 7/4/2013 Endorsement Number NOTICE ENDORSEMENT - CANCELLATION OR NON-RENEWAL We agree with you that your Policy is amended to include the following additional provisions. 1. Your Policy will not be: XX Cancelled by us until we provide at least: 10 days prior written notice if we cancel your Policy for Non-payment of Premium; 30 days prior written notice if we cancel your Policy for The following reasons: Any reason other than non-payment of premium. Ncn-renewed by us until at least days prior written notice is given to the person or entity named in 2. below. 2. Person or Entity: City of Ashland 20 East Main Street Ashland OR 97520 All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated insurers, takes effect on the effective date of said Policy at the hour stated in said Policy and expires concurrently with said Policy unless another effective date is shown above. By Authorized Representative James F. Willging (No signature is required if issued with the Policy or if it is effective on the Policy Effective Date) - - - - - - - - James F. Willging Countersigned by Authorized Representative 256423 (Ed. 10/05) CERT NO.: 10711799 (IRV ) Sd di Mrena 12/2012013 5:01:02 W Pdge 7 of 7