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HomeMy WebLinkAboutInsurance Certificate: Abraham Contracting Inc ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDYYYY) 5/28/2014 le~ 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 NAME: KPD Insurance PHONE FA% o Brut 541-741-0550 Np : - -1.674 PO Box 784 Aic. N M Springfield OR 97477 ADDRESS: INSURERS AFFORDING COVERAGE NAIC N INSURER A: orth Pacific InsU rance C4 2 INSURED ABRA01 C INSURER B Abraham Contracting, Inc. INSURER C 6152 River Banks Rd INSURER D: Grants Pass OR 97527 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 441102976 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 ADDLI$O BR POLICY EFF POLICY EXP LIMITS LTR INSR MD POLICY NUMBER MMIDDNYYY MMMDIYYYY A GENERAL LIABILITY 21129216 /1/2014 11/2015 EACH OCCURRENCE $1,000,000 X OAMAGt T15RENTED COMMERCIALGENERAL LIABILITY PREMISES Eaoccerence $100,000 CLAIMS-MADE 1XI OCCUR MED EXP(My one person) $5,000 PERSONAL S Ao/INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO- LOC $ JECT A AUTOMOBILE LIABILITY C27129216 11/2014 11/2015 Ea accident 1000,000 x ANY AUTO BODILY INJURY (Per person) $ ALLOWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-0WNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per aoddenl UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY OFFICER/MEM ER EXCLUDED?ECUrNEā‘ NIA EL EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE-EA EMPLOYE $ If yes, describe under OE SCRIPTION OF OPERATIONS belay E.L. DISEASE -P000Y LIMIT $ A Equipment Floater 21129216 11/2014 /1/2015 'AII Risk' $500 Deductible Actual Cash Value DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is re0ulred) City of Ashland is Additional Insured per attached form CG8579 (05/05). 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. 455 Siskiyou Blvd Ashland OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 8679 05 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY MASTER PAK PLUS@ FOR CONSTRUCTION (OREGON) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX Subject Page Blanket Additional Insured (Owners, Lessees or Contractors) 2 Fire, Lightning, Explosion and Sprinkler Leakage Damage to Premises You Rent 3 Non-Owned Watercraft 4 Supplementary Payments (Bail Bonds) 4 Personal And Advertising Injury - Electronic Publication Extension 5 Aggregate Limits (Per Location) 5 Aggregate Limits (Per Project) 5 Voluntary Property Damage Coverage 8 Off Premises Care, Custody or Control Coverage 6 Newly Formed or Acquired Organizations 7 Duties in the Event of Occurrence, Offense, Claim or Suit 7 Bodily Injury (Mental Anguish) 8 e Waiver of Transfer of Rights of Recovery Against Others Medical Payments 8 Broad Named Insured 8 Broadened Mobile Equipment 8 Incidental Malpractice Liability 8 Non-Owned Aircraft 9 Property Damage - Elevators 9 CG 8679 05 06 Includes copyrighted material of ISO Properties, inc., with its permission Page 1 of 9 = 587 00 6. VOLUNTARY PROPERTY DAMAGE COVERAGE At your request, we will pay for "loss" to property of others caused by your business operations. The most we will pay for this coverage is $500 each "occurrence." The "loss" must occur during the policy period. The "occurrence" must take place In the "coverage territory". "Loss" means unintended damage or destruction. "Loss" does not mean disappearance, abstraction or theft. This coverage does not apply to: 1. Damage arising out of the use of any "auto"; 2. Property you own, occupy, rent or lease from others; or 3. Property on your premises for sale, service, repair or storage. None of the other policy exclusions apply to this coverage. If the policy to which this endorsement is attached is written with a property damage liability deductible, - the deductible shall apply to Voluntary Property Damage. The limit of coverage stated above shall not be reduced by the amount of this deductible- 9. OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE A. We will pay those sums that you become legally obligated to pay as damages because of "property damage" to personal property of others while in your or your "employees" care, custody or control or real property of others over which you or your "employees" are exercising physical control if the "property damage" arises out of your business operations. This Coverage is subject to sections S., C., D. and E. below. B. Exclusions This Insurance shall not apply to: 1. "Property damage" of property at premises owned, rented, leased, operated or used by you; 2. "Property damage" of property while in transit; 3. The cost of repairing or replacing: (a) Any of your work defectively or incorractly done by you or by others on your behalf; or (b) Any product manufactured, sold or supplied by you, unless the "property damage" is caused directly by you after delivery of the product or completion of the work and resulting from a subsequent undertaking; or 4. "Property damage" of property caused by or arising out of the "products-completed operations hazard". C. Limits Of Insurance - The most we will pay for "property damage" under this Section 9. is $25,000 for each "occurrence". The most we will pay for the sum of all damages covered under this Section 9. because of "property damage" Is an annual aggregate limit of $25,000. The Limits Of Insurance provided under this Section 9. are inclusive of and not in addition to any other limits provided in the policy or endorsements attached to it. D. Deductible - We will not pay for "property damage" in any one "occurrence" until the amount of "property damage" exceeds $250. If the policy to which this endorsement is attached contains a "property damage" deductible, that deductible shall apply if it is greater than $250. E. In the event of "property damage" covered by this endorsement, you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges. CG 6579 05 05 Includes copyrighted matedal of ISO Properties, Inc., wfth Its permisslon. Page 6 of 9 E 592 CC 10. NEWLY FORMED OR ACQUIRED ORGANIZATIONS A. Paragraph 4. of Section II -Who Is An Insured is deleted and replaced by the following: 4. Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States of America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no similar insurance available to that entity. However. a. Coverage under this provision applies only until the expiration of the policy period in which the entity was acquired or incorporated or organized by you. b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before the entity was acquired or incorporated or organized by you. c. Coverage B does not apply to 'personal and advertising injury' arising out of an offense committed before the entity was acquired or incorporated or organized by you. d. Records and descriptions of operations must be maintained by the first Named Insured. B. This Section 10. does not apply to newly formed or acquired organizations if coverage is excluded either by provisions of the Coverage Part or by other endorsement(s) attached to it. 11. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT A. The requirements in Section IV - Conditions, Paragraph 2.a., that you must see to it that we are notified of an 'occurrence' applies only when the "occurrence" is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A member or manager, If you are a limited liability company; 4_ An executive officer or designee, if you are a corporation; 5. A trustee, if you are a trust; or 5. A designee, if you are any other type of organization. B. The requirements in Section IV - Conditions Paragraph 2.b. that you must see to it that we receive written notice of a claim or "suit" will not be considered breached unlessthe breach occurs after such claim or "suit" is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. A member or manager if you are a limited liability company; 4. An executive officer or designee, if you are a corporation; 5. A trustee, if you are a tout; or 5. A designee, if you are any other type of organization. Knowledge of an "occurrence," claim or "suit" by the agent, servant or "employee" of any insured shall not in itself oon5ttute knowledge of the insured unless an officer or designee shall have received notice from its agent, servant or "employee". 12. BODILY INJURY Paragraph 3. of the definition of "bodily injury" in the Section V - Definitions is replaced by the following: 3. "Bodily Injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. CG 8579 05 05 Includes copyrighted material or ISO Properties, Inc., Wth its permission. Page 7 of 9 E 593 W C. Paragraph b.(1)(b) of Condition 4. Other Insurance (Section IV - Conditions) is replaced by the following: (1) That is Fire, Lightning, Explosion or Sprinkler Leakage insurance for premises rented to you or temporarily occupied by you with the permission of the owner; D. Paragraph 9.a. of the definition of "Insured contract" in Section V- Definitions Is replaced by the following: 9. "Insured contract" means: a. A contract for the lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damages by fire, lightning. "explosion" or sprinkler leakage to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract"; E. The following definition is added to Section V - Definitions: "Expioslon" means a sudden release of expanding pressure accompanied by a noise, a bursting forth of material and evidence of the scattering of debris to locations further than would have resulted by gravity alone. "Explosion" does not include any of the following: 1. Artificially generated electrical current Including electrical aroing that disturbs electrical devices, appliances or wires; 2. Rupture or bursting of water pipes; 3. Explosion of steam boilers, steam pipes, steam engines or steam turbines owned or leased by you, or operated under your control; or 4. Rupture or bursting caused by centrifugal farce. 3. NON-OWNED WATERCRAFT Subparagraph g.(2) of Paragraph 2., Exclusions of Section I - Coverage A is replaced by the fallowing: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; 4. SUPPLEMENTARY PAYMFNTS In the Supplementary Payments - Coverages A and B provision: The limit for the cost of bail bonds in Paragraph 1.b. is changed from $250 to 51000. Co 8579 05 05 Includes copyrighted materiel of I60 Properties, Inc., with Rs pennssIm. Page 4 of 9 E 590 OD 5. PERSONAL AND ADVERTISING INJURY - ELECTRONIC PUBLICATION EXTENSION Paragraphs 14.b., d. and e. of Section V - Definitions are replaced by the following: It. Malicious prosecution or abuse of process; d. Oral, written, televised, videotaped or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; The following Is added to Paragraph 14. "Personal and Advertising Injury" of Section V - Definitions; h. Discrimination or humiliation that results In Injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation Is: (1) Not done intentionally by or at the direction of: (a) An insured; or (b) Any "executive officer" director, stockholder, partner or member of the insured; and (2) Not directly or indirectly related to the employment, prospective employment or termination of employment of any person or persons by any insured. Subparagraphs It. and c. of 2., Exclusions of Section I - Coverage B - Personal And Advertising Injury Liability are replaced by the following: b. Material Published With Knowledge Or Falsity "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication of material, if done by or at the direction of the insured with knowledge of its falsity; c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication of material whose first publication took place before the beginning of the policy period; 6. AGGREGATE LIMITS OF INSURANCE (PER LOCATION) The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. -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. 7. AGGREGATE LIMITS OF INSURANCE (PER PROJECT) The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your projects away from premises owned by or retried to you. CG 8679 06 05 Includes copyrighted material of ISO Properties, Inc., vft its permission. Page 5 of 9 e sal m 1. BLANKET ADDITIONAL INSURED (Owners, Lessees Or Contractors) (Includes a Primary/Non-Contributory provision) Section 11- Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy in a written contract or written agreement. The written contract or written agreement must be currently in effect or becoming effective during the term of this policy and executed prior to the "bodily injury," "property damage" or "personal and advertising injury." A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. The Insurance provided the additional insured is limited as follows: A. The person or organization is only an additional insured with respect to liability caused by your negligence and: 1. Arising out of real property, as described in a written contract or written agreement, that you own, rent, lease or occupy; or 2. Caused by your ongoing operations performed for the additional insured. The insurance provided the additional insured in 1.A.2. above does not apply to: a. Coverage A - Bodily Injury and Property Damage Liability, Coverage B - Personal and Advertising Injury Liability or defense coverage under the Supplementary Payments arising out of an architect's, engineer's or surveyors rendering of or failure to render any professional services including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specificatlons; and (2) Supervisory, inspection, architectural or engineering activities. b. "Bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) that was performed by or on behalf of the additional insured(s) at the site where the covered operations have been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project. 0. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of Insurance as stated in the Declarations of this policy and defined in Section III - Limits Of Insurance of this policy, whichever are less. These limits are Inclusive of and not In addition to the limits of insurance available under this policy. C. The insurance provided the additional insured does not apply to the liability resulting from the negligence of the additional insured. CG 8579 05 05 Includes copyrighted materlal of ISO Properties, Inc., Wth Its permission. Page 2 of 9 E 5W 03 D. As respects the coverage provided to the additional insured under this endorsement, Section IV- Conditions is amended as follows: 1. The following Is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim, or Suit: An additional Insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense, that may result in a claim or "suit" under this Insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have Insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. 2. The following is added to Condition 3. Legal Action Against Us: We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. 3. The following is added to Paragraph a., Primary Insurance of Condition 4. Other Insurance; If the additional insured's policy has an Other Insurance provision making its policy excess, and a Named Insured has agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. 4. The following is added to Paragraph b., Excess Insurance of Condition 4. Other Insurance: Except as provided in Paragraph 4.a. Primary Insurance as amended above, any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis. In the event an additional insured has other coverage available for an "occurrence" by virtue of also being an additional insured on other policies, this insurance is excess over those other policies. 2. FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT If Damage To Premises Rented To You under Coverage A is not otherwise excluded from this policy, the following applies: A. The lest paragraph of 2. Exclusions of Section I - Coverage A is replaced by the following: If Damage To Premises Rented To You is not otherwise excluded, Exclusions c. through n. do not apply to damage by fire, lightning, "explosion" or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits Of Insurance. B. Paragraph 6. of Section 111 - Limits Of Insurance is replaced by the Following: 6. Subject to ti. above, the higher of $300,000 or the Damage To Premises Rented To You Limit shown in the Summary of Limits and Charges section of this policy is the most we will pay under Coverage A for damages because of "property damage" to premises rented to you or temporarily occupied by you with the permission of the owner arising out of any one fire, lightning, "explosion" or sprinkler leakage incident. CG 8579 05 05 includes copyrighted material of ISO Propntim, inc., with its permission. Page 3 of 9 E58000 13. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization for whom you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the agreement. 14. MEDICAL PAYMENTS If Coverage C Medical Payments is not otherwise excluded, the Medical Expense Limit provided by this policy shall be the greater of: A. $10,000; or B. The amount shown in the Declarations. 15. BROAD NAMED INSURED Paragraph 2.a.(1)(d) of Section 11- Who Is An Insured is replaced by the following: (d) Arising out of his or her providing or failing to provide professional health care services. However, this exclusion does not apply to nurses, emergency medical technicians or paramedics who are employed by you to provide medical or paramedical services to your employees. 16. BROADENED MOBILE EQUIPMENT Paragraph 121(1) of Section V - Definitions is replaced by the following: (1) Equipment designed primarily for (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning provided that vehicles have a Gross Vehicle Weight of 1,000 pounds or greater; 17. INCIDENTAL MALPRACTICE LIABILITY Paragraph 3. of Section V - Definitions is replaced by the following: 3. 'Bodily injury' means bodily injury, sickness, disease or "incidental medical malpractice" sustained by a person, including mental anguish or death resulting from any of these at any time. The following is added to Section V - Definitions: 23. "Incidental medical malpractice" means injury arising out of the negligent rendering or failure to render medical or paramedical services to persons by any physician, dentist, nurse, emergency medical technician or paramedic who is employed by you to provide such services to your employees, provided you are not engaged in the business or occupation of providing any services referred to in this definition. 18. NON-OWNED AIRCRAFT The following is added to Subparagraph g, of 2., Exclusions of Section I - Coverage A Bodily Injury And Property Damage Liability: (6) An aircraft with a paid crew, that Is hired, chartered or loaned but is not owned by any insured. CG 8679 05 06 Includes copyrighted material of ISO Properties. inc., with is permission. Page 8 of 9 E 504 00 19. PROPERTY DAMAGE-ELEVATORS The following Is added to Subparagraph J. of 2., Exclusions of Section 1. Coverage A Bodily Injury And Property Damage Liability: Paragraphs (3) and (4) of this exclusion do not apply to damages that result from the use of elevators. All other terms and conditions of your policy remain unchanged. CG 8679 06 05 Includes copyrighted material of 150 Properties, Inc., with Its permission. Page 9 of 9 E essoo