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HomeMy WebLinkAboutInsurance Certificate: Alpine Environmental ALPIN-5 OP ID: SH ACORL7 F DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/24/2015 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 NCONTACT AME: Joe Schultz Pieper Ramsdell Agency PHONE 503-397 0714 Fo X, No 503-397-0674 P.O. Box 596 A/c No EXt St. Helens, OR 97051 E-MAIL Joe Schultz ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Homeland Insurance Co of NY INSURED Alpine Environmental INSURER B: Consultants, LLC 12208 Antioch Road INSURER C White City, OR 97503 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 DAMAGE TO RENTED CLAIMS-MADE ~ OCCUR X X 793-00-32-64-0001 05/07/2015 05/07/2016 PREMISES Ea occu«ence $ 50,00 NonOwned Auto MED EXP (Any one person) $ 5,00 Hired Auto PERSONAL & ADV INJURY $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,00 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea so dent ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED ❑ N /A (Mandatory in Ni E L DISEASE - EA EMPLOYEE $ If yes describe under DESCRIPT ION OF C,PERATIONS below E L DISEASE -POLICY LIMIT S A Pollution Liab 793-00-32-64-0001 05/07/2015 05/07/2016 Limit 2,000,00 A Professional Liab 793-00-32-64-0001 05/07/2015 05/07/2016 Limit 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Per attached endosements OBENV GE 301, OBENV GE 319, and OBENV GE 320 CERTIFICATE HOLDER CANCELLATION C I TYAS H SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, OR, its ACCORDANCE WITH THE POLICY PROVISIONS. elected officials, officers and employees AUTHORIZED REPRESENTATIVE 20 East Main Street Ashland, OR 97520 I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Policy Number: 793-00-21-6-1-0001- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - FORM I This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Pei-son or Organization: Any person or organi-anon for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scone o- insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (b) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain the same. OBENV GE 301 (02 11) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E-INSURED THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IV - CONDITIONS, 8. Other Insurance, is amended by adding the following paragraph: This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement, that this insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same. OBENV GE 319 (02 11) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E-INSURED Policy Number: 793-00-21-04-0001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. SECTION IV - CONDITIONS, 13. Transfer of Rights of Recovery Against Others To Us is deleted and replaced with the following: 13. Transfer of Rights of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this policy, those rights are transferred to us. The insured must do nothing to impair them. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. Any recovery will be paid first to us until all amounts we have spent on a claim or suit have been reimbursed. The insured expressly waives the right to be made whole by any such recovery. 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. All other terms and conditions remain the same. OBENV GE 320 (04 11) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E-INSURED