Loading...
HomeMy WebLinkAboutInsurance Certificate: Carollo Engineers Accw7or CERTIFICATE OF LIABILITY INSURANCE DATEIMWDDfYYYYI lh.~' 6/2312014 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 NTACT _ Risk Strategies Company - NAME: Risk Strategies Company 2040 Main Street, Suite 450 PHONE 949-242-9240 FAX No: Irvine, CA 92614 I=.N rtl ADDRESS: syoungarisk-strategies.com INSURERS AFFORDING COVERAGE NAICN www.risk-strategies.com CA DOI License No. OF06675 INSURER A: Hanover Insurance Company 22292 INSURED INSURERS Carollo Engineers, Inc. 2700 Ygnacio Valley Road, #300 INSURER C: Massachusetts Bay Insurance Company 22306 Walnut Creek CA 94598 INSURER D: Continental Casual Company 20443 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 20617101 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 ADD BR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MM/DDIYYYY - COMMERCIAL GENERAL LIABILITY ✓ ZHF8944892-03 12131/2013 12131/2014 EACH OCCURRENCE $ $1,000,060 CLAIMS-MADE O OCCUR PREMISES ErenceS $1,000,000 MED EXP(Any one rson) - S $25,000 PERSONAL B ADV INJURY $ $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ $2,000,000 POLICY O JE° FILOC PRODUCTS - COMP,OP AGO S $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBIN IN LE LIMIT 5 Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) 5 HIRED AUTOS AUTOS NON-OWNEO PROPERTY DAMAGE $ UMBRELLA LIAR OCCURS EACH OCCURRENCE S EXCESS LUU3 CLAIM-MADE AGGREGATE 5 DED RETENTIONS S C WORKERS COMPENSATION WDF8957499-05 12131/2013 12/31/2014 I/ STATUTE ERH AND EMPLOYERS' LIABIUTY ANY PROPRIETORMARTNERIEXECOTIVE YIN E. L. EACH ACCIDENT $ $1,000,000 OFFICER/MEMBER EXCLUDED? F-1 NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE 3 $1,000,000 If yes, desvibe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT 5 $1,000,000 D Professional Liability I AEH288354410 7/4/2014 7/412015 Each Claim: Unlimited Prior Acts Aggregate: $1,000,000 Deductible: $400,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may tee attached If mom space Is required) Operations as per contract on file with Insured. Professional Liability is written in aggregate limits of liability not less than the amount shown. RE: Disinfection Byproduct Improvements. Project 2012-05. Carollo Project 9228A.00. City of Ashland, Oregon, and its elected officials, officers and employees are included as additional insureds with respects to General Liability and this policy is Primary & Non-Contributory. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Ashland Main St97reereet ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (gSTN) Mike Christian ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20617101 (IR ) Sandi Morew 6/23/2014 5:04:01 PM (PM) Page 1 Of Architects and Engineers The following policy language is from Commercial General Liability Coverage Forms The following are mandatory forms on the policy identified on the Certificate of Insurance: 421-0080(01 03) COMMERCIAL GENERAL LIABILITY SPECIAL BROADENING ENDORSEMENT Additional Insured by Contract, Agreement or Permit Under SectionII -WhoIsAninsured,Paragraph 4.is added as follows: 4- a. Any person or organization with whom you agreed,because of a written contract, written agreement or permit to provide Insurance Is aninsured,bul only with respect to: (1) "Your work" for the additional Insured(s) at the location designated in the contract, agreement or permit; or (2) Premises you own, rent, lease or occupy. This Insurance applies one primary basis 1 that is required by the written contract, written agreement or permit. b. This provision does not apply: (1). Unless the writtencontract or written agreement has been executed or permit has been issued prior to the "bodily Injury', "property damage',personal injury" or 'advertising injury". (2) To any person or organization Included as an Insured by an endorsement Issued by us and made part of this Coverage Part. (3) To any person or organization included as an insuredunder item 2ofthis endorsement (4) Toanylessotofequipment: (a) After the equipment lease expires; or o O b Ifthe "bodily Injury'", "property damage", "personal injury" or "advertising Injury" arses out of sole negligence the lessor. (5) To any: (a) Owners or other Interests from whom land has been leased which takes place after the lease for the land expires; or (b) Managers or lessors of premises if: (i) The occurrence takes place after you cease to be a tenant in that premises: or (ii) The "bodily injury, "property damage", "personal injury" or "advertising injury" arises out of structural alterations, new construction ordemolition operations performed by or on behalf of the manager or lessor. • Aggregate Limit Per location (1) Under Section III - Limits of Insurance the General Aggregate Limit applies separately to each of your "locations Owned by or rented to you. (2) Under Section V -Definitions, definition 23. is added as follows: 23. "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. CG 2503(05 09) DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT ' Aggregate Limit of Insurance (Per Project) COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Your projects away from premises owned b or rented to you A. For all sums which the Insured becomes legally obligated to pay as damages caused by "occurrences" under Section I-Coverage A, and for all medical expanses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown I n the Schedule above: 1- A separate Designated Construction Project General Aggregate Limit appliesto each designated construction project, and that Limit is equal tothe amount of the General Aggregate Limit shown In the Declarations. 2. The Designated Construction Project General Aggregate Limit Is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily Injury" or 'property damage' included In the "products-completed operations hazard", and for medical expenses under Coverage C regardless of the number of: Includes copyrighted material oflnsuranm Services Offices, Inc.,with its permission CERT .0.: 30611101 (IR ) Sandi Moreno 6/23/2014 5:04:01 PM (PVr) Page 2 of 7 a. Insured's; b. Claims made or "suits" brought; or c. Persons ororganizatiohs making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate limit for that designated construction project. Such payments shall not reduce the GeneralAggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above 4. The limits shown in the Declarations for Each Occurrence, Damage to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the Insured becomes legally obligated to pay as damages caused by"occurrences"under Section 1-Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project show in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate limit or the Products-completed Operations Aggregate Limit, whichever Is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage forliability arising out of the "products-completed operations hazard" Is provided, anypayments for damages because of "bodily Injury" or "property damage' Included in the products-completed operations hazard" will reduce the Products- completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or If the authorized contracting partiesdeviate from plans,blueprints, designs, specifications ortime tables, the project will still be deemed to be the same construction project. E. The provisions of Section I I I-Limits Of Insurance not otherwise modified by thisendorsement shall continue to apply as stipulated. 421-0452 (06 07) OTHER INSURANCE-PRIMARY AND NON-CONTRIBUTORY (ADDITIONAL INSURED) Additional Insured by Contract, Agreement or Permit Amended-Primary & Non-Contributory The following is added to Section IV -Commercial General Liability Conditions 4. Otherlnsurance a. AdditionalInsured's If you agree in a written centraclwritten agreement or permit that the insurance provided to any person or organization Included as an Additional Insured under Section I I -Who is An Insured, is primary and non-contributory, the following applies: If other valid and collectable Insurance is available to the Additional Insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: 1. Primary Insurance - This Insurance is primary to other Insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other Insurance available to the Additional Insured except: 1. For the sole negligence of the Additional insured, II. When the Additional Insured Is an Additional Insured under another primary liability policy; or III. When 2. below applies. If this Insurance is primary, our obligations are not affected unless any of the other Insurance Is also primary. Then, we will share with all that other Insurance by the method described in-3.below. 2. Excess Insurance This Insurance is excess over: (1) Ally of the other Insurance,whether primary, excess,contingent or on any other basis: (a) That is fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for "your work', (b) That is Fire insurance for premises rented to the Additional Insured or temporarily occupied bythe Additional Insured with permission of the owner, (c) That is Insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property damage" to premises rented to the Additional Insured or temporarily occupied by the Additional with permission of the owner, or (d) If the loss arises out of the maintenance or use of aircraft. "autos" or watercraft to the extent not subject to Exclusiong. of SectionI -CoverageA - BodilyInjury And Property Damage Liability. Includes copyrighted material of Insurance Services Offices, Inc., with its permission CERT NO.: 20617101 (IRVN) Sandi Moreno 6/23/2011 5:04:01 PM (POP) Page 3 of 7 V When this insurance is excess, we will have no duty under CoveragesA or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the Insured's rights against all those other Insurefs. When this insurance is excess over other Insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: 1) The total amount that all such other insurance would pay for the loss in the absence of this Insurance; and 2) The total of all deductible and self-Insured amounts under all that other I nsurance. We willshare the remaining loss, if any, withany other Insurance that is not described in this Excess Insurance provision and was not bought specifically toapply In excess of the Limits of Insurance shown in the Declarations of this Coverage Part. 3. Method Of Sharing If all of the other Insurance permits contribution by equal shares, we will follow this method also under this approach each Insurer contributes equal amounts until it has paid Its applicable limit of Insurance or none of the loss remains, whichever comes first. If any of the other Insurance does not permit contribution by equal shares,wewill contribute by limits. Under this method,each Insurer's share is based on the ratioof Its applicable limitof Insurance to the total applicable limits of insurance of all insurers. CG0001(1207) COMMERCIAL GENERAL LIABILITY COVERAGE FORM • Separation of Insured's Except with respect to the Limits of Insurance,and any rights orduties specifically assigned in this Coverage Part to the first Named Insured, this Insurance applies: a. As if each Named Insured were the only Named Insured: and b. Separately to each insured against whom claim is made or "suit'is brought. CG 2404(0509) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY TO US • Waiver of Subrogation COMMERCIALGENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERARTIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Persons or organizations with whom you have a written contract executed prior to the "bodily Injury" or"property damage," that requires you to waive your rights of recovery The following is added to Paragraph8.Transfer Of Rights Of Recovery Against Others To Us of Section IV- Conditions: We waive any right of recovery we may have against the person or organization shown In the Schedule above 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 the person or organization shown in the Schedule above. Authorized Representative 12/31/2013 Name Insured: Carollo Engineers, Inc. Policy NO. ZHF8944892-03 Additional Insured: Any person or organization with whom the named insured agreed in a written contract to name as additional insured. City of Ashland, Oregon, and its elected officials, officers and employees This Notice does not form a pad of the insurance contract. No coverage is provided by this Notice, nor can it be consboed to replace any provisions of the policy (including its endorsements). If there is any conflict between this Notice and the policy (including its endorsements), the provisions of the policy (including its endorsements) shall prevail. Includes copyrighted material of Insurance Service Offices, Inc., with its permission COPT NO.'. 20617101 (IRW) Sa dl moreuo 6/23/2014 5:04:01 PM (PVT) Page 4 of 7 Named Insured: Carollo Engineers, Inc. Policy No.ZHF8944892-03 NOTICE OF CANCELLATION TO DESIGNATED ENTITY(S) (Including Nonpayment of Premium) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART SCHEDULE Name of Designated Entity Mailing Address or Email Address Thirty (30) Days Notice Cittyy of Ashland 20 East Main Street Ashland OR 97520 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. If we cancel this policy for any reason, including nonpayment of premium, we will give written notice of such cancellation to the Designated Entity(s) shown in the Schedule. Such notice may be delivered or sent by any means of our choosing. The notice to the Designated Entity(s) will state the effective date of cancellation. Unless otherwise noted in the Schedule above, such notice will be provided to the Designated Entity(s) no less than the number of days In advance of the effective date of cancellation that we are required to provide to the Named Insured for such cancellation. If the reason for cancellation is nonpayment of premium, however, we will provide ten days notice. Such notice of cancellation is solely for the purpose of Informing the Designated Entity(s) of the effective date of cancellation and does not grant, alter, or extend any rights or obligations under this policy. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. ~l,~tCft,~-ter Authorized Representative or countersignature (where required by law) Includes copyrighted materials from ISO, Inc. 2003 Page 1 of 1 CERT NO.: 20611101 (IR ) Sandi Moreno 6/23/2014 5:04:01 PM (PO'1) Page 5 of 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. IT IS HEREBY UNDERSTOOD AND AGREED THATTHIS POLICY SHALL NOT BE CANCELLED BY THE COMPANY WITHOUT 30 (THIRTY) DAYS WRITTEN NOTICE, TO THE ASSURED,EXCEPTTHAT IN THE EVENT OF NON-PAYMENT OF PREMIUM THIS POLICY MAYBE CANCELLED WITHIN 10 (TEN) DAYS WRITTEN NOTICE. Certificate Holder: City of Ashland 20 East Main Street Ashland OR 97520 Nothing herein contained shall be held to vary, alter, waive orextendany of the terms, conditions, agreements or limitation of the policy other than as above states. (Completion of the following, including countersignature, is required to make this endorsementeffective only when it is Issued subsequent to preparation of the Policy.) Effective 12/31/2013 this endorsement forms a part of Policy No. WDF8957499-05 Issued to Carollo Engineers, Inc. By Massachusetts Bay Insurance Company Date oflssue Countersignedby ~.LA.tU-ur Authorized Representative of the Company 331-0230 1003 Page 1 of 1 CERT NO.: 20617101 (INVN) Sandi Moreno 6/23/2014 5:04:01 PM (PCT( Page 6 of NA PROFESSIONAL LIABILITY AND POLLUTION For All the Commitments you Make INCIDENT LIABILITY INSURANCE POLICY INSURED: Carollo Engineers, Inc. Policy AEH288354410 Effective7/4/2014 Endorsement Number NOTICE ENDORSEMENT - CANCELLATION OR NON-RENEWAL We agree with you that your Policy is amended to include the following additional provisions. 1. Your Policy will not be: XX Cancelled by us until we provide at least: 10 days prior written notice if we cancel your Policy for Non-payment of Premium; 30 days prior written notice if we cancel your Policy for The following reasons: Any reason other than non-payment of premium. Non-renewed by us until at least days prior written notice is given to the person or entity named in 2. below. 2. Person or Entity: City of Ashland 20 East Main Street Ashland OR 97520 All other terms and conditions of the Policy remain unchanged. - - - - - - - - This endorsement, which forms a part of and is for attachment' to the Policy issued by the i designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy and expires concurrently with said Policy unless another effective date is shown above. By Authorized Representative James F. Willging (No signature is required if issued with the Policy or if it is effective on the Policy Effective Date) James F. Willging . Countersigned by Authorized Representative 256423 (Ed. 10/05) CEAT NO.: 20617101 (Sava) Sandi Moreno 6/33/3014 5:04:01 PM (PM3 Page 7 of 7