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HomeMy WebLinkAboutInsurance Certificate: OBEC Consulting Engineers CITY RECORDER OP ID: BH ACORO° CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDM'YY) 03/1812014 - 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 Phone: 800-338-1391 CONTACT 701 Market St, Ste. 1100 Fax: 888-621-3173 FHCONN Ert: AIL NO: St Louis, MO 63101 EWAIL Jeff B. Connelly ADDRESS: PRODUCERRm0:OBEC-01 CUSTOME INSURERS AFFORDING COVERAGE NAIC0 INSURED OBEC Consulting. Engineers INSURER A: Hartford Insurance Company 22357 920 Country Club Road INSURER B: Eugene, OR 97401-2231 INSURER C - - - 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. ILm TYPE OF INSURANCE POLICY NUMBER MPONWLI DYIYYYY MMN YD UMITS Lm GENERAL LIABILITY EACH OCCURRENCE $ - 2,000,00 A X COMMERCIAL GENERAL LIABILITY 84SBWPA4035 0312012014 03/20/2015 PREMISES Ea oaunence E 2,000,00 CLAIMS-MADE ~ OCCUR MED EXP (Any one person) $ 10,00 PERSONAL 8 ADV INJURY $ 2,000,00 PROF. LIABILITY EXCLUDED GENERAL AGGREGATE $ 4,600,000 GENT AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMP/OP AGG $ 4,000,00 POLICY X PRO LOC $ .IECT AUTOMOBILE UABILRY COMBINED SINGLE LIMIT $ 2,000,00 A X ANY AUTO 84UEGPF0127 03/2012014 0312012015 (Ea accident BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY I NJURY(Per accident E SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Peraccident NON-OWNEDAUTOS S $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,00 A EXCESS LUIB CLAIMS-MADE 84XHGYH1723 0312012014 0312012015 AGGREGATE $ 5,000,00 DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION X WCSTATU- OT'- AND EMPLOYERS' LIABIUTY A ANY PROPRIETOR/PARTNERIEXECUTNE Y 84WBGBJ0746 0312012014 03120/2015 E.L. EACH ACCIDENT $ 1,000,00 OFFICERNEMBER EXCLUDED? NIA (MeMetor In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,00 Ifyes, desa under DESCRIPTION OF OPERATIONStlel. E.L. DISEASE - POLICY LIMIT E 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ANaoh ACORD 101, Additioml Remits Schedule, It more apace is requlmd) RE: Calls, Guanajuato Resurfacing Project- The City of Ashland, Oregon and its elected officials, officers and employees are included as additional insured for above coverages except WC as required by written contract. Coverage is primary and non-contributory to any other insurance carried except Ombrepla. (GLAI, AutoAI) CERTIFICATE HOLDER CANCELLATION CITYOF 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. Attn: Karl Olson - 90 N. Mountain Avenue AUTHORIZE/D R~EPRESENTAIWE Ashland, OR 97520 o CL c~ 'T © 198888.`2009 ACORD CORPORATION.. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 84SBWPA4035 BUSINESS LIABILITY COVERAGE INSURED: OBEC Consulting Engineers ADDITIONAL COVERAGES BY WRITTEN CONTRACT, AGREEMENT OR PERMIT This is a summary of the Coverage provided under the following: - - BUSINESS LIABILITY COVERAGE FORM SS 00 08 WHO IS AN INSURED (Section C) states that the following is also an additional insured: Additional Insured by Contract, Agreement or Permit Any person or organization is an additional insured when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the executive of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under the provision only for that period of time required by the contract, agreement or permit. With respect to the insurance afforded to the additional insured, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specification: or (b) Supervisory, inspection, architectural or engineering activities. Primary and Non-Contributory to Other Insurance When Required by Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Waiver of Subrogation If you have waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided you waived your rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. Rev 5.13 , POLICY NUMBER: 84UEGPFO127 AUTO LIABILITY COVERAGE INSURED: OBEC Consulting Engineers ADDITIONAL COVERAGES WHEN REQUIRED BY WRITTEN CONTRACT This is a summary of the Coverage provided under the following: COMMERCIAL AUTOMOBILE COVERAGE FORM HA9916 Additional Insured if Required by Contract When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" with regard to the ownership, maintenance or use of a covered "auto." Primary and Non-Contributory if Required by Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Waiver of Subrogation We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payment we make for damages under the Coverage Form. Rev 5. 13