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HomeMy WebLinkAboutInsurance Certificate: Portland Engineering ,ac CERTIFICATE OF LIABILITY INSURANCE D IDD/YYYY) `"mil 6//25/ 25/2014 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 the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Rim Schnetzky Ward Insurance Agency PHONE (541) 687-1117 FAX (541) 342-8280 PO Box 10167 E-MAIL ADDRESS: kim@wardinsurance. net INSURERS AFFORDING COVERAGE NAIC # Eugene OR 97440 INSURERA:Cincinnati Specialty 13037 INSURED INSURERB:Cincinnati Insurance Companies Portland Engineering, Inc. INSURER CContinental Casualt Company 7675 High Banks Road Suite 1 INSURER D: INSURER E : Central Point OR 97502 INSURER F: COVERAGES CERTIFICATE NUMBER:14/15 GL/AL/UMB/PROF/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. INSR TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP LTR POLICY NUMBER M DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY AMA RENTE PREMISES Ea occurrence $ 100,000 A CLAIMS"-MADE FX1 OCCUR X Y SU0039055 7/1/2014 7/1/2015 MED EXP (Any one person) $ Exclude X $1,000 BI/PD DED PERSONAL & ADV INJURY $ 1,000,000 PER OCCURR GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC WA STOP GAP LIABILITY $ 1,000,000 AUTOMOBILE LIABILITY Ea accident) SINGLE LIMIT 1 000,000 B ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED NP0148589 7/1/2014 7/1/2015 BODILY INJURY Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTIONS SU0039058 7/1/2014 7/1/2015 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN TORY LIMITS I FIR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ C PROFESSIONAL LIABILITY & CH288379629 7/1/2014 7/1/2015 LIMIT $2,000,000 POLLUTION LIABILITY DEDUCTIBLE $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The 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 & 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 ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9mnne~ m The A('-(1RI1 name anri Innn arc renicfereri mnrke of Al OP1111