HomeMy WebLinkAboutInsurance Certificate: RH2 Engineering Inc
CERTIFICATE OF LIABILITY INSURANCE 5/20/ 014
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(le8) 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 rWMEACT Allen Pugitt CPCD
Sammami sh Insurance, Inc. PHONE (425) 898-8780 F'~ . (x25)836-2865
704 228th Ave NE, PMB 373 'MAIL .Allen Fugitt@men.com Do. INSURER(S) AFFORDING COVERAGE WLIC4
Sammamish WA 98074 INSURERANartford Casual Ina. Co. 9424
INSURED INSURERe:Sentinel Insurance Co. Ltd 11000
RH2 ENGINEERING INC INSURERCContinental Casualty Company
22722 29TH DR BE STE 210 NSURERD
I :
NSURER E:
BOTHELL WA 98021 INSURER F:
COVERAGES CERTIFICATE NUMBERICL1452002405 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 ADM SUBR POLICY EFF POLICY EXP
LT POLICYNUMBER MIMDD (MM1DDffYYY1 LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY P EMI a0Mllenw $ 300,000
A CIMS-MADE OCCUR X 2SBRNK5475 /16/2013 /16/2014 MED E%P (Myona pemm~) $ 10,000
PERSONAL 6 ADV INJURY $ 2,000,000
GENERAL AGGREGATE $ 4,000,000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 4,000,000
X POLICY PR0. LOC S
JF~
AUTOMOBILE LIABILITY MXEO SINGLE LIMIT
1,000,000
B ANY AUTO BODILY INJURY (Per person) $
ALL OWNED X SCHEDULED 2UECHY3821 /16/2013 /16/2014 BODILY INJURY(Perawasm) 6
AUTOS AUTOS
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
AUTOS (Per ecodeffil
Medical me S 10,000
A UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 2,000,000
X EXCESS LIAR CVJM&MADE 2SBANK5475 /16/2013 /16/2014 AGGREGATE $ 2,000,000
DED RETENTIONS S
A - - V.C STATU-. X OTH-
LIM FR
MEMPLOYERS' LIABIDTY YIN
ANY PROPRIETORMARTNERIEXECUTIVE❑ NIA E.L. EACH ACCIDENT S 1 000 000
OFFlCERWEMBER EXCLUDEDY 28BA1e15475 /26/2013 /16/2014
(WnOaWgnN10 E.L. DISEASE - EA EMPLOYE $ 1,000,000
U yea.IPTION O =ON uMer
DESCR
F OPERATIONS DNOw E.L. DISEASE -POLICY LIMB S 11000,000
C Professional Liability H004312321 /29/2014 /29/2015 Per Oowrrome $3,000,000
Claims Made DeaarUde $150,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUaeh ACORD 101, A&HU.1 Remarks ScheduN, N mom spew Is rwMr.cQ
The City of Ashland is named an additional insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
520 N Main St.
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
F ugitt CPCO/JONA
ACORD 25 (20110105) ®198$-2010 ACORD CORPORATION. All rights reserved.
INSn25bmM51 n.___ The A Cnon n.,..e .-A 1 .,.,.....e,.L~...w ,...dr. s nencn -