HomeMy WebLinkAboutInsurance Certificate: OBEC Consulting Engineers (2)
,aco CERTIFICATE OF LIABILITY INSURANCE /DATE 03/2015M/DOMYY)
' 04/03/2
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 CONTACT
NAME:
Marsh Sponsored Programs PHONE FAX
a division of Marsh USA Inc. E-MAIL •800-338-1391 A/c
701 Market Street, Ste. 1100 No:888-621-3173
ADDRESS: acecclientrequest@marsh.com
St. Louis MO 63101 _ INSURER(S) AFFORDING COVERAGE NAIC
INSURER A: Sentinel Insurance Company Ltd 11000
INSURED INSURER B: Hartford Casualty Insurance Company 29424
OBEC Consulting Engineers
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.
INSR TYPE OF INSURANCE I NS WVD R SU R POLICY NUMBER MPOMIDDIY FF MMIDD YYYP LIMITS
A GENERAL LIABILITY y 84SBWPA4035 03/20/2015 03/=0/_-O1c EACH OCCURRENCE $2,000,000
OAMAGE
X COMMERCIAL GENERAL LIABILITY Prof. Liab. Excl. TORENTED
PREMISES Ea occurrence 52,000,000
CLAIMS-MADE 111 OCCUR MED EXP (Any one person) $10,000
PERSONAL & ADV INJURY 52,000,000
GENERAL AGGREGATE 54,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4,000,000
JECT RO-- LOC $
POLICY X P
A AUTOMOBILE LIABILITY Y 84UEGPF0127 03/20/2015 03/20/2016 COMBINED SINGLE LIMIT
Eaaccidem S2,000000
X ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) S
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS AUTOS Per accident S
5
B X UMBRELLA LIAB X OCCUR 84XHGYH1723 03/20/2015 03/20/2016 EACH OCCURRENCE $5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
DIED RETENTIONS 10 000 $
A WORKERS COMPENSATION 84WBGBJ0746 03/20/2015 03/20/2016 WCSTATU- ~OTH-
AND EMPLOYERS LIABILITY Y / N X TORY LIMITS E
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S1,000,000
OFFICER/MEMBER EXCLUDED? N I A
(Mandatory in NH) E.L. DISEASE - EA EMPLOY S1,000,000
- - If yes, describ"nder
DESCRIPTIONOFOPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required)
Pro; ect: ARRA Project No.2007-17, Oak-Ann Street Section (Hersey Street
Sidewalk. Reconstruction) - City of Ashland is included as additional insured
for above coverages except WC as required by written contract.
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
AUTHORIZED REPRESENTATIVE
51 WINBURN WAY
ASHLAND, OR 97520
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ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD