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HomeMy WebLinkAboutInsurance Certificate: Copeland Construction LLC ACORIDTM CERTIFICATE OF LIABILITY INSURANCE DATE 04/30/2014 30/2014 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 NCONTACT AME: Jessica Embree Zarosinski-Leavitt Insurance Agency of Oregon Pa"c°NeEat: (503)639-4220 AIc,Ne:(503)639-4449 Leavitt Group of Portland R:gessica-embree@leavitt.com 8285 Sid Nimbus Ave, Suite 120 INSURER(S) AFFORDING COVERAGE NMc0 Beaverton, OR 97008 INSURER A: American Hallmark Ins. Co. of Texas INSURED Copeland Construction LLC INSURER B: 321 Pruett Rd. INSURERC: Eagle Point, OR 97524 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 14/15 GL/AL 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 "UL 51.11:1. LTR TYPE OF INSURANCE HER VIVID POLICY NUMBER MMIDDIYYYY MMIDDNYYY LIMITS GENERAL LIABILITY 44CL464731-0 0610312014 06103/2015 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence $ 100,000 CLAIMS-MADE Fx7OCCUR MED EXP (Any one person) $ 5,000 A PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGG $ 2,000,00 POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY 44CL464731-0 0610312014 0610312015 Ea accident $ 1,000,00 X ANY AUTO BODILY INJURY (Pat person) $ ALL OWNED SCHEDULED A AUros AUTOS BODILY INJURY (Par accident) 8 HIRED AUTOS ANUTOSWNED Per accident) $ E X UMBRELLA LIAB OCCUR 44CU476415-0 06/0312014 0610312015 EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION - ANDEMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTRrFj--~ E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? u NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ H yBS describe under DESCRIPTION OF OPERATIONS below _ EL DISEASE - POLICY LIMB $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE ~Myyy 20 E Main St As land, OR 97520 Jessica Embree Exec JDE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD