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HomeMy WebLinkAboutInsurance Certificate: Carollo Engineers (3) _ATE I Ali. ' ® CERTIFICATE OF LIABILITY INSURANCE 0912012 FD /0DIYYYY) 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(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 A NAME: Marsh Sponsored Programs PHONE .1.877-320-9393 FAX 515-365-0895 a service of Seabury & Smith, Inc. E-MAIL° E ac No PO Box 14404 ADDRESS: nskmana ement@marsh m.com aROOUCER Vendor lD: 31459 Des Moines, IA 50306-9686 INSURE S AFFORDING COVERAGE NAIC # INSURED INSURER ~A:~Old Re ublic Insurance Com an 24147 Carollo Engineers INSURER a: 4600 East Washington St., #500 INSURER C : Phoenix, AZ 85034 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 DU USR POLICY EFF POLICY EXP LTFt vivn l POLICY NUMBER / MMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMA COMMERCIAL GENERAL LIABILITY GETO RENTED CLAIMS-MADE D OCCUR MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE 19 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS -COMP/OPAGG POLICY PRO- LOG - $ AUTOMOBILE LIABILITY COMBINED SINGLE $ i 000,000 X LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS f A SCHEDULED AUTOS X L437056.14 10/1712014 10/17/2015 BODILY INJURY (Per accident) $ PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ UMBRELLA UAB OCCUR ' EACH OCCURRENCE EXCESS UAB CLAIMS-MADE AGGREGATE DEDUCTIBLE :RETENTION $ I WORKERS COMPENSATION ` WC STATU- OTH- AND EMPLOYERS' UABtUTY Y I N C)R ANY PROPRIETORIPARTNER/EXECUTNE ❑ OFFICMMEMBER EXCLUDED? E_L. EACH ACCIDENT (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS 1 LOCATIONS i VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GPBR: 2260 Policy provides protection for any & all operationsrjobs performed by the named insured where required by written contract Certificate holder is an Additional Insured where required by written contract Waiver of Subrogation included where required by written contract. Insurance is primary and noncontributory. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland, OR 97520 ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are reaistered marks of ACORD