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HomeMy WebLinkAboutInsurance Certificate: Devon Pereira AC RCW CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/24/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICANE 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 CONTACT NAME: Marsh Sponsored Programs PHONE FAX a division of Marsh USA Inc. Alc No Ext:800-338-1391 AIC No: 888-621-3173 E-MAIL 701 Market Street, Ste. 1100 ADDRESS: acecclientrequest@marsh.com St. Louis MO 63101 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Sentinel Insurance Company Ltd 11000 INSURED INSURER B: Hartford Casualty Insurance Company 29424 B Devon Pereira INSURER C: 920 Country Club Road Eugene, OR 97401-2231 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. INSIR TYPE OF INSURANCE IN UR SWVD POLICY NUMBER MM/DD/YYY MM/DD/YYY LIMITS A GENERAL LIABILITY 84SBWPA4035 03/20/2015 03/20/2C16 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY Prof. Liab. Excl. DAMAGE TO RENTED PREMISES (Eaoccurrence) $2 000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GENERALAGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OPAGG $4,000,000 POLICY X JECOT LOC $ A AUTOMOBILE LIABILITY Y 84UEGPF0127 03/20/2015 03/20/2016 COMBINED SINGLE LIMIT Eaaccident $2,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTCS AUTOS Per accident L 1 1 $ B X UMBRELLA LIAB X OCCUR 84XHGYH1723 03/20/2015 03/20/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION$ 10, 000 $ A WORKERS COMPENSATION 84WBGBJ0746 03/20/2015 03/20/2016 WCSTATU- OTH- AND EMPLOYERS LIABILITY YIN X TORY LIMITS ER - ANYPROPRIETOR/PARTNER/EXECUTIVEâť‘ N/A E. L. EACH ACCIDENT $1,000,000 OFFICE R/M Ed SER EXCLUDED? (Mandatory in NH) E.L. DISEASE- EA EMPLOYE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Calls Guanajuato Resurfacing Project- The City of Ashland, Oregon and its elected officials, officers and employees are included as additional insured for above coverages except WC as required by written contract. Coverage is primary and non-contributory to any other insurance carried except Umbrella. (GLAI, AutoAI) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland Attn: Kari Olson AUTHORIZED REPRESENTATIVE 90 N. Mountain Avenue Ashland, OR 97520 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD BUSINESS LIABILITY COVERAGE FORM Summary SS 00 08 04 05 Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. c. Method Of Sharing If all 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, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Waiver of Subrogation If you have waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided you waived your rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage Rev 5.14 Page 2 of 2 POLICY NUMBER: 84SBWPA4035 BUSINESS LIABILITY COVERAGE INSURED:OBEC Consulting Engineers SS 00 08 04 05 ADDITIONAL COVERAGES BY WRITTEN CONTRACT, AGREEMENT OR PERMIT This is a summary of the coverage provided under the following form (complete form available): BUSINESS LIABILITY COVERAGE FORM SS 00 08 04 05 Additional Insured When Required by Written Contract, Written Agreement or Permit WHO IS AN INSURED under Section C. is amended to include as an additional insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products completed operations hazard", but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products completed operations hazard". The person(s) or organization(s) are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under the provision only for that period of time required by the contract, agreement or permit. With respect to the insurance afforded to the additional insured, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specification: or (b) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D. Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. Liability And Medical Expenses General Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. Other Insurance If other valid and collectible insurance is available for a loss we cover under this Coverage Part, our obligations are limited as follows: When You Add Others As An Additional Insured To This Insurance: That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract: This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non-Contributory To Other Insurance When Required By Contract: If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Rev 5.14 Page 1 of 2 POLICY NUMBER: 84UEGPF0127 COMMERCIAL AUTOMOBILE ,'NSURED: OBEC Consulting Engineers HA 99 16 09 10 ADDITIONAL COVERAGES WHEN REQUIRED BY WRITTEN CONTRACT This is a summary of the coverage provided under the following form (complete form available): COMMERCIAL AUTOMOBILE COVERAGE FORM HA 99 16 09 10 Additional Insured if Required by Contract Paragraph A.1. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add: When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" under paragraphs a. or b. of Who is and Insured with regard to the ownership, maintenance or use of a covered "auto." Primary and Non-Contributory Only with respect to insurance provided to an additional insured in 1.D. Additional Insured If Required by contract, the following provisions apply: 1) Primary Insurance When Required By Contract: This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance Clause. 2) Primary and Non-Contributory To Other Insurance When Required By Contract: If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty 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 insurers. 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 that this 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 insurance. We will share the remaining loss, if any, by method described in Other Insurance 5.d. Waiver of Subrogation We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payment we make for damages under the Coverage Form. Rev 5.14 Page 1 of 1