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HomeMy WebLinkAboutInsurance Certificate: Crandall Arambula PC Client#: 328663 CRANDARA2 ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) (MM/D 5 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: Kibble & Prentice, a USI Co PR PHONE 206 441-6300 FAX 610-362-8530 A/C, No, Ext): (A/C, No): 601 Union Street, Suite 1000 ADM RIESS: PL.CertRequest@kpcom.com Seattle, WA 98101 INSURER(S) AFFORDING COVERAGE NAIC # INSuRER A : Travelers indemnity Company 25658 INSURED INSURER B : Travelers Indemnity Company _ 25658 Crandall Arambula, P.C. INSURER c : SAIF Corporation 36196 520 SW Yamhill Suite 4 INSURER D : XL Specialty Insurance Company 37885 Portland, OR 97204 INSURER E: Charter Oak Fire Insurance Comp 25615 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 CONTRACTOR 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 1 LTR INSR ''WVD POLICY NUMBER A GENERAL LIABILI OF INSURANCE _ '.ADDL'~SUBR,,. 680181 OL202IND14 05/04/201Y LIMIT TYPE 5 05/04/2016 DEACH OCCURRENCE AMAGE TO RENTED s2,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $1 ,000,000 CLAIMS-MADE i', X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY s210001000 GENERAL AGGREGATE _ 54,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _ PRODUCTS - COMP/OP AGO $4,00_0,000 _ POLICY X. PECOT- LOC AUTOMOBILE LIABILITY BA181 OL82814GRP 5/04/2015 05/04/2016 COMBINE, SINGLE LIMIT 1,000,000 E I_ {Ea accident) $ ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY ( NON OWN D PROPERTY DAMAGE accident) S AUTOS I. AUTOS X HIRED AUTOS X AUTOS (Per accident) $ $ B X UMBRELLA LIAB CUP6B5343251447 5/04/2015 05/04/201 EACH occuRRENCE I S1,000,000 EXCESS LIAB ,XOCCUR _ CLAIMS-MADEAGGREGATE $1,000,000 - - DED RETENTION $ $ _ TATU- C WORKERS COMPENSATION 905493 09/01/2014 09/01 /2015 X~ ORY LIMITS I _ EORH AND F ICERIM in B EMPLOYERS' ER EXCLUDE LIABILITY EXECUTIVE~YN E.L. D SEASECEDA EMPLOYEE' $500,000 ORCER/MEMER EXCLUDED? N/A' - $500 000 If yes, describe under DESCRIPTION OF OPERATIONS bellow E.L. DISEASE - POLICY LIMIT. 5500,000 D Professional DPS9721771 5/04/2015 05/04/201 $2,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / 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 an Additional Insured on the General Liability Policy, with respects to operations of the Named Insured. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE 0900 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S15038982/M15036706 RRBZP COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED INSURANCE (Section III) for this Coverage (Section II): Part. Any person or organization that you agree in a B. The following is added to Paragraph a. of 4. "contract or agreement requiring insurance" to in- Other Insurance in COMMERCIAL GENERAL clude as an additional insured on this Coverage LIABILITY CONDITIONS (Section IV): Part, but only with respect to liability for "bodily in- However, if you specifically agree in a "contract or jury", "property damage" or "personal injury" agreement requiring insurance" that the insurance caused, in whole or in part, by your acts or omis- provided to an additional insured under this Cov- sions or the acts or omissions of those acting on erage Part must apply on a primary basis, or a your behalf: primary and non-contributory basis, this insurance a. In the performance of your ongoing opera- is primary to other insurance that is available to tions; such additional insured which covers such addi- b. In connection with premises owned by or tional insured as a named insured, and we will not rented to you; or share with the other insurance, provided that: c. In connection with "your work" and included (1) The "bodily injury" or "property damage" for within the "products-completed operations which coverage is sought occurs; and hazard". (2) The "personal injury" for which coverage is Such person or organization does not qualify as sought arises out of an offense committed; an additional insured for "bodily injury", "property after you have entered into that "contract or damage" or "personal injury" for which that per- agreement requiring insurance". But this insur- son or organization has assumed liability in a con- ance still is excess over valid and collectible other tract or agreement. insurance, whether primary, excess, contingent or The insurance provided to such additional insured on any other basis, that is available to the insured is limited as follows: when the insured is an additional insured under d. This insurance does not apply on any basis to any other insurance. any person or organization for which cover- C. The following is added to Paragraph 8. Transfer age as an additional insured specifically is Of Rights Of Recovery Against Others To Us added by another endorsement to this Cover- in COMMERCIAL GENERAL LIABILITY CON- age Part. DITIONS (Section IV): e. This insurance does not apply to the render- We waive any rights of recovery we may have ing of or failure to render any "professional against any person or organization because of services". payments we make for "bodily injury", "property f. The limits of insurance afforded to the addi- damage" or "personal injury" arising out of "your tional insured shall be the limits which you work" performed by you, or on your behalf, under agreed in that "contract or agreement requir- a "contract or agreement requiring insurance" with ing insurance" to provide for that additional that person or organization. We waive these insured, or the limits shown in the Declara- rights only where you have agreed to do so as tions for this Coverage Part, whichever are part of the "contract or agreement requiring insur- less. This endorsement does not increase the ance" with such person or organization entered limits of insurance stated in the LIMITS OF into by you before, and in effect when, the "bodily CG D3 81 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission COMMERCIAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- erage Part, provided that the "bodily injury" and sonal injury" offense is committed. "property damage" occurs, and the "personal in- D. The following definition is added to DEFINITIONS jury" is caused by an offense committed: (Section V): a. After you have entered into that contract or "Contract or agreement requiring insurance" agreement; means that part of any contract or agreement un- b. While that part of the contract or agreement is der which you are required to include a person or in effect; and organization as an additional insured on this Cov- c. Before the end of the policy period. Page 2 of 2 © 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes the copyrighted material of Insurance Services Office. Inc., with its permission