Loading...
HomeMy WebLinkAboutInsurance Certificate: Portland Engineering Inc A` °RO® CERTIFICATE OF LIABILITY INSURANCE 6/OAT. 6/2014YYYI 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 - C NAME- ONTACT Kim Schnetaky Ward Insurance Agency PHONE (541) 687-1117 FAX (561)342-8280 PO Box 10167. E-MAIL .kim@wardinsurance. net INSURERS AFFORDING COVERAGE NAIL 4 Eugene OR 97440 INSURER A Cincinnati Specialty 13037 INSURED INSURERS Continental Casualty Company Portland Engineering, Inc. INBURERC: 7675 High Banks Road Suite 1 INsuRFRn - INSURERE: Central Point OR 97502 IN URER F: COVERAGES CERTIFICATENUMBER:13/14 GL/AL/UMB/PROP/POLL 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. IN SR TYPE OF INSURANCE POLICY ADDL SUM NUMBER POLICY EFF MPOLICY EXP LIMITS LTR J= Jim GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 X rnMMFRONAI r.FNFRA1 I MRr ITY S 100,00 PREMICE6 (E. ,.I A CWMS-M40E Fx_1OCCUR X Yr SU0039055 /1/2013 7/1/2014 MED EXP(Any we peram) S Excluded X $1,000 BI/PD DED PERSONALS ADV INJURY 3 1,000,00 PER OCCURRENCE WIL STOP GAP LIABILITY GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: $110001000 PRODUCTS - COMP/OP AGG S 2,000,00 POLICY X PRO- LOG $ AUTOMOBILE LIABILITY 1 000 000 (E, =06 s ANY AUTO BODILY INJURY (Pw person) S A ALL OWNED SCHEDULED AUTOS AUTOS 9V0039055 7/1/2013 /1/2014 BODSY INJURY (Pw ACridenq S X HIVED AUTOS X ANON-O NJED PROPERTY DAMAGE $ $ X UMBRELLA UAS X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE S 5,000,000 DED RETENTION 500039058 7/1/2013 /1/2014 $ RYUMUj1 WORKERS COMPENSATION A T - IVOIC AND EMLOYERTLIABILITY YIN ANY PROPMETOR,PARTNEWPXECUTIVE NIA E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUOEO? (Mendetory M NH) E.L. DISEASE ~ EA EMPLOYE S If yes. descd6e V Wer OESCRIPTION OF OPER;.TION$ Wow E. L. DISEASE - POLICY LIMIT $ B PROFESSIONAL LIABILITY 6 8288379629 7/1/2013 /1/2014 LIMIT $2,000,00 POLLUTION LIABILITY DEDUCTIBLE $5,00 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, A4dltIonal Romans Schedule, If mom space is r uhed) City of Ashland, Oregon and its elected officials, officers and employees are named as additional insured as respects to work performed by the named insured under written contract agreement and per attached CSIA405-A. Completed operations apply per attached CSIA405-A. Coverage is primary S non-contributory per attached CSIA405-A. Waiver of subrogation is applicable per attached CSIA405-B. Designated construction project(s) general aggregate limit applies per attached CG2503. 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. 20 E Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE M Holcomb/TRACEE t,~-_~~ -G//~-a -•-5. ACORD 25 (2010105) ®1988.2010 ACORD CORPORATION. All rights reserved. INS0250nim. I M The arnIon name and Innn are ronlolerod mar4c of Ar npn THIS ENDORSEMENT CHANGES THE POLICY: PLEASE READ IT CAREFULLY. ADDITIONAL INSURED' - OWNERS, LESSEES OR CONTRACTORS ,AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - O.PERATIONS AND COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. :Section II - Who is an Insured is dated (wrap-up) insurance program has amended to include as an additional insured been :provided by the prime contrac- any person or organization when. you and torfproject.manager or owner of the con; such person or organization have agreed in struction project in. which you are 'in- writing in a contract or agreement that such volved. person or organization.be added. as an addi- tional insured on; your policy,. but only to .the :3. "Bodily injury", "property damage" or "per_. extent that the liability, is caused by 'your sonal and advertising injury to any em- work" performed for that additional insured ployee of you or to, any obligation of the and only to the extent that such liability is additional. insured to indemnity another caused by your negligence,. acts or omissions because of.damages arising out of. such or the negligence, acts or omissions of those injury. acting onyour behalf. 4. "Bodilyinjury% "property damage" or "per- If not specified otherwise in the written con- sonat and advertising injury` for which the tract or agreement, a. person's or organiza- Named Insured Is afforded no coverage tion's. status as an additional insured under under this policy of insurance. this endorsement. ends one year after your C. With respect to the.insurance.afforded to operations for that additional insured are com- these additional insureds, SECTION III - LIM- pleted. The written contract or agreement ITS OF INSURANCE is:amended to include: must be currently in,effect or become effective during the term of this Coverage Part. The The limits applicable to the additional insured. contract or agreement must be executed prior are those specified in the written contract or to the "bodily injury", "property damage" or agreement or in the Declarations of this Cov- "personal and advertising injury to which this erage Part, whichever is less. If no limits are endorsement pertains, specified in.. the: written contractor agreement 5. With respect to the insurance afforded to the limits applicable to the additional insured are those specified in the Declarations of this these additional insureds; the following addi- Coverage Part. The limits of insurance are. in- tional exclusions apply: ciusive of and not in addition to the limits of This insurance does not apply to: insurance shown in the Declarations. 1. "Bodily injury", 'property damage" or D. With respect to the insurance afforded to "personal and advertising injury arising these additional Insureds, SECTION IV - out of the rendering of, or the failure to COMMERCIAL GENERAL LIABILITY COW render, any professional architectural, en- DITIONS, 4. Other Insurance' is amended to pineeringorsurveying. services, including: include: a. The preparing; approving, or failing to. Any, coverage provided herein will be excess prepare. or approve, maps, shop over any other valid and collectible insurance: drawings, opinions, reports, surveys; available to the additional insured whether field orders, change orders or draw= primary, excess, contingent oron any other ings and specifications; or basis unless you have agreed in a written con- b. Supervisory,. inspection, architectural tract or written agreement executed prior to or engineering.activities. any loss 'that .this insurance will be primary. 2. "Bodily Injury or "property damage" aris- This insurance will be noncontributory only if ing out-of "your work" for which a consolk you have so agreed in a written contract or Includes copyrighted material of Insurance CSIA405 (08109)-A Services Office, Inc:, with Its permission. Pagel of :2 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization 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 that person or organization for which you have agreed to in a written contract to provide said waiver. Includes copyrighted material of ISO CSIA405 (08109).B Properties, Inc., with its permission. Page 1 of 1 written agreement executed prior to any toss and'this(coverage.is determined to be primary. Includes copyrighted material of Insurance csIA 05 (o"9)-A Services office, Inc., with Its permission. Page:2 of 2 POLICY NUMBER: CSU0039055 COMMERCIAL GENERAL LIABILITY CO 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): when required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes le- shown in the Ueclarations nor shall they gally obligated to pay as damages caused by reduce any other Designated Construe- occurrences" under Section I - Coverage A, tion Project General Aggregate Limit for and for all medical expenses caused by acci- any other designated construction project dents under Section I - Coverage C, which shown in the Schedule above. can be attributed only to ongoing operations at a single designated construction project 4. The limits shown in the Declarations for shown in the Schedule above: Each Occurrence, Damage To Premises Rented To You and Medical Expense 1. A separate Designated Construction continue to apply. However, instead of Project General Aggregate Limit applies being subject to the General Aggregate to each designated construction project, Limit shown in the Declarations, such lim- and that limit is equal to the amount of the its will be subject to the applicable Desig- General Aggregate Limit shown in the nated Construction Project General Ag- Declarations. gregate Limit. 2. The Designated Construction Project B. For all sums which the insured becomes le- General Aggregate Limit is the most we gally obligated to pay as damages caused by will pay for the sum of all damages under "occurrences" under Section I - Coverage A, Coverage A, except damages because of _ and for all medical expenses caused by acci- "bodily injury" or "property damage" in- dents under Section I - Coverage C, which cluded in the "products-completed opera- cannot be attributed only to ongoing opera- tions hazard", and for medical expenses tions at a single designated construction proj- under Coverage C regardless of the ect shown in the Schedule above: number of: 1. Any payments made under Coverage A a. Insureds; for damages or under Coverage C for medical expenses shall reduce the b. Claims made or "suits" brought; or amount available under the General Ag- c. Persons or organizations making gregate Limit or the Products-completed claims or bringing "suits". Operations Aggregate Limit, whichever is applicable; and 3. Any payments made under Coverage A for damages or under Coverage C for 2. Such payments shall not reduce any medical expenses shall reduce the Des- Designated Construction Project General ignated Construction Project General Ag- Aggregate Limit. gregate Limit for that designated con- C. When coverage for liability arising out of the struction project. Such payments shall not "products-completed operations hazard" is reduce the General Aggregate Limit provided, any payments for damages be- CG 25 03 05 09 0 Insurance Services Off Ice, Inc., 2008 Page 1 of 2 ❑ cause of "bodily injury" or "property damage" doned and then restarted, or if the authorized included in the 'products-completed opera- contracting parties deviate from plans, blue- tions hazard" will reduce the Products- prints, designs, specifications or timetables, completed Operations Aggregate Limit, and the project will still be deemed to be the same not reduce the General Aggregate Limit nor construction project. the Designated Construction Project General Aggregate Limit. E. The provisions of Section III - Limits Of Insur- ance not otherwise modified by this endorse- D. If the applicable designated construction proj- ment shall continue to apply as stipulated. ect has been abandoned, delayed, or aban- GG 25 03 05 09 © Insurance Services Off Ice, Inc., 2008 Page 2 of 2 ❑