Loading...
HomeMy WebLinkAboutInsurance Certificate: Osmose Utilities Services _ CITY RECORDER °RO® CERTIFICATE OF LIABILITY INSURANCE 6%12%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 _certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Christie Geiger NAME: Fiist Niagara Risk Management, Inc PHONE (716)819-5500. FAX '(716)819 E-MAIL 726`Ezchange'Street Suite 900 D .Christie.Geiger@fnrm.com INSURER(S) AFFORDING COVERAGE NAIC 4 Buffalo NY 14210 INSURERANat'1 Union Fire Ins Co of PA 9445 INSURED INSURER B:Travelers Pro Cas Co of Am 5674 Osmose Utilities Services Inc INSURERC:LlO d's of London 85202 980 Ellicott Street INSURER D: INSURER E: Buffalo NY 14209 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 OUS LAWE REVISIONNUMBER: 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 ADDLSUBR POLICY NUMBER MMNDA(yr MMICDA~ LTR LIMBS GENERAL LABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY $ 1,000,000 PREMISES (Ea ~rra,,oeI A CLAIMS-MADE 111 OCCUR X X 267145 /1/2014 /1/2015 NED EXP(My one Person) $ 10,000 X Contractual Liability PERSONAL d ADV INJURY $ 1,000,000 X XCU included _ I GENERALAGGREGATE... $ -2,000,000 V1 'GEML AGGREGATE LIMIT APPUESPER:' PRODUCTS. COMP/OVAGG $ 21600,000 ° POLICY X PRO- X LOC - $ AUTOMOBILE UABIL" COMBINED SINGLE LIMIT ..I Ee attic n 3,000,,000' X BODILY INJURY (Per Pelson), A ANY AUTO - ALL OWNED SCHEDULED` X X ,500794 ;/l/'2014: 1/1/2015 BODILY INJURY (Per accident) $ I AUTOS- AUTOS.., NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Pero itl nt - $ X UMBRELLA LAB X OCCUR X X EACH OCCURRENCE $ 25,000,000 A EXCESS LIAB CLAIMS-MADE E 080850586 /1/2014 /1/2015 AGGREGATE $ 25,000,000 DED X RETENTION 10,00 $ A WORKERS COMPENSATION X 18962552 ADS /1/2019 /1/2015 X WC STATU- OTH-TORY I unrq FR ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOWPARTNEWEXECUTIVE 18962553 ME /1/2019 /1/2015 E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? NIA 18962553 CA /1/2019 /1/2015 (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, descdbe uNw DESCRIPTION OF OPERATIONS below E 1. OISEARF - F L ICV tIMIT a 1 Ono nnn B Leased/Rented Equipment T6603420P452TIL14 /1/2019 /1/2015 unit 1,400,000 C Professional Liability OSMO0113/POSM00213 /1/2013 /1/2014 Per claim/agg 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (AKach ACORD 101,AddiOonal Remarks Schedule, K more space la rmIulred) The City of Ashland, Oregon, and its elected officials, officers and employees are Additional Insured on a primary and non-contributory basis in regard to the above Liability policies when required by executed written contract. A Waiver of Subrogation is included when required by executed written contract. Workers Compensation coverage is extended to the state of Oregon. 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. 90 N. Mountain Avenue Ashland, OR 97520 AUTHORIZED REPRESENTATIVE M Bonetto/CGEIGE ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INSD25r?mmnslm Tho ArnPn name and Innn nm ronictoroel mnrkc of ArnRn