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HomeMy WebLinkAboutInsurance Certificate: Hardey Engineering & Associates DATE (MM/DD/YYYY) ACC> CERTIFICATE OF LIABILITY INSURANCE 5/18/2015 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 endorsements . PRODUCER CONTACT NAME__ Kendall YeaW Protectors Insurance, LLC PIAIC No. HONE Ext):(541)842-2963 acNo)(541)772 190 P.O. Box 4669 E-MAIL Medford OR 97504 ADDRESS: _ INSURER(S)_AFFORDING COVERAGE NAIC # INSURER A:Ohlo~e rl Insurance X40$2____ INSURED HARDE-1 INSURERB_Ohio_Casualty tnsuranc 74 Hardey Engineering & Associates Inc INSURERC: _ PO Box 1625 INSURER -D : Medford OR 97501-0124 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 156951552 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 ADDL SUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN SR WVD ~ POLICY NUMBER MM/DDYYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY BZS55569489 5/12/2015 /12/2016 EACH OCCURRENCE $1,000,000 IX COMMERCIAL GENERAL LIABILITY DAMA E TO RENTED PREMISES-LEaoccurrence $1,000,000 CLAIMS-MADE K" OCCUR MED EXP (Any one person) $15,000 I _ j PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 I GE 'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $2,000,000 RO- LOC $ POLICY i P JECT F7 A AUTOMOBILE LIABILITY BAS55569489 /12/2015 5/12/2016 UMBINED SINGLE LIMIT (Eaaccicien~t 1 $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ "AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS i- AUTOS lil (Per accident B UMBRELLA LIAB X OCCUR US055569489 5/12/2015 5/12/2016 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- ; T2RY_LIMITSR AND EMPLOYERS' LIABILITY Y / N - I ANY PROPRIETOR/PARTNER/EXECUTIVE t OFFICER/MEMBER EXCLUDED? N / A EL. EACH ACCIDENT (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ _ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S Per Claim Limit Annual Aggregate Deductible i DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Miscellaneous on call services. Certificate holder is named as additional insured per policy form BP7996(0609): III I i~ 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 Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE f ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD BUSBVESSOWNERS 8p 70 $1108 09 Section II • Liability Is a mended as toll9ws: 1. SUPPLEMENTARY PAYMENTS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Paragraph L(1)(b) of A Coverages 4 replaced by the following; (b) Up to $30DO for cost of bell bond required beause of accidents or traffic law vlolstlons arising cut of BUSIN ESSOW NERS LIABILITY EXTENSION ENDORSEMENT the use of any vehicle to which Business Uabluty Coverage for'bod6y IMury" applies. We do not have to furbish the bonds. This endorsement modines Insurance provided under the following: Paragraph Id.p)(d) of A Coverage a Is replaced by the following; BUSINESSOWNERS COVERAGE FORM (dj All seasonable expenses incurred by the insured el our request to assist us In the investigation or datana or the claim or "evil", Including actual loss of earnings up to $500 a day becavaa of time off from work. SUBJECT P8 11. BROADENED COVERAGE FOR DAMAGE TO PREMISES RENTED TO YOU With respect to the coverage provided under this endorserrank, Section 11 • Liability Is amended as follows: AGGREGATE LIMITS OF INSURANCE 3 1. The flu[ paragraph of B.I. Exclusions • Applicable To Bu tress Liability Coverage is deleted and replaced by the following: AMENDMENT OF INSURED CONTRACT DEFINITION 4 With respect to the premises which ere rented to you or temporarily occupied by you with the permb• elon of the owner, Exclusions e, it., e., g., IS, k., 1., m, as and o, do not apply to "property damage". BAIL BONGS 1 2. Paragraph D.Z. Liability And Medical Expenses Urchs Of Insurance Is deleted and replaced by the /ol"owing: BIANKET ADO(710NAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 2 The most we will pay under this endorsement for the sum of an damages because of all "property damage" to premises while rented to you or temporerny occupied by you with the permisslon of the BODILY INJURY 3 owner [s the LI WI of Insurance shown In the Declaration. 3. Paragraph D.S. LIabitity And Medical Expenses Umlts Of Insurance is deleted. BROADENED COVERAGE FOR DNMG£TO PREMISES RENTEDTO YOU I III. INCIDENTAL MEDICAL MALPRACTICE DUTIES IN THE EVENTOP OCCURRENCE, OFFENSE,CLAIM OR SUIT 3 Exeluslon 1.1.(4)dots not apply (0 Incidental Medical Malpractice Injury coverage. The following is added to F. LIABILITY AND MEDICAL EXPENSES DEFINITIONS: INCIDENTAL MEDICAL MALPRACTICE 2 23. "Incidental Medial Malpractice Injury" means bodily Injury arising out of the rendering of or failure to render, during the polity period, the following Services: LOSSOF EARNINGS 1 a. medical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food a bev. eu9es In connection therewith; or MOBILEEOUIPMENT 2 b. the fumishing w it4penslrg ofd(.g, or medical, dental of surgical supplies aeppRances. This coverage dart not apply to: NEWLY FORMED OR ACQUIRED ORGANIZATIONS 2 1, expenses Incurred by the Insured for first-aid to others at the time of in accident and the Duties In the Event of Otcurrence, Claim or Suit Condition b ems Mad l"Onhergly; PERSONAL AND ADVERTISING INJURY 3 2. any Insured engaged In the business or occupation of providing any of the Services descrlbed - under e. end b. above; SUPPLEMENTARY PAYMENTS 2 3. Injury caused by any Indemnitee R such Indemnhee Is engaged In the business or occupation of providing any of the aervites described Undies, and Is. above. IV. MOBILEEGUIPMENT 1. Section C. Who Is An insured is amended to include any person driving^mobl!e equipment" with your permisslon. V. BLANKET ADDITIONAL INSURED (OWNERS, CONTRACTORS OR LESSORS) 1. Section C. Whole An I.sufed Is emandad to Include Is an Insured any person or organlzollo t whom you era required to name IS an additional Insured on this po[Icy Under a written conVoct of written agreement. The Written commit or agrwment must be: a. currently In Strad or becoming effective during the farm of this policy; I rid b. exetutedprlortotha"bodtlylnjuty","proptrtydamape",'personafandadveNstngln)ury'. hOgv LWeMMutual eeAanuV Cemw. y A7 dvAte Nemt6 BP 70980809 Iatl~uteOY+bAa.aeaMdd asweur.enS«v1o. mitre, k,a.ridr its pon:u!e. Papal 014 hap any MaaMaena C.pel. turpNe rM BP d. 79950609 hdad•e Coerdshud w:aY.d el W.I.-S-[-oa<e, M., fth it, P"Won Paget of4 2. The Insurance provided the additional Insured It llmlted at follows: VIII,DUTTES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT a. The PerwnororOwGationls onlyanaddillonallmmed with respect to lUbRity raising out of 1. TnenqulrementlnE Liability And Medical Expenses General Conditions paragraph 2a. that you must (I) Real property, IS diserbed in a written contract or written ageemenk, you own, rani, lease, see to it that we are notlned of an "occurrence" or offense which may result In a claim applies only malnislnoroccupy; when the "occurmnce" (a known to any Insured listed In Paragraph C.I. Who Is An Insured or any "employee" authorized by you to g[ve or receive notice of en "occurrence" or claim (2) Caused in Iwhole or In nsurance, part aby your ble to the a goperall performed for those (pawed. 2. The requirements In E. Llablthy And Medical Expenses General Conditions paragraph 2.b. the( you b. The limits of Insuuns applicable to the additional Injured nsurad us thou specified In the written must See to It that we recalls notice of a claim or "suh" will net be considered breached unless the contract or written agreement or the limits available under this policy, as stated In the Declare- breach occurs after such Claim or "suit" Is known to any insured listed under Paragraph C.I. Whole An 119.1, whichever are less. These limits are inclusive Mandator In addition to the Imes of Insurance Insured or any "employee" Authorized by you to give or receive notice of in "occurrence" or claim. available underthI3 policy. IX. BODILY INJURY t. The huulana provided the additional Insured does no lipplyto: Pa BODILY 3.ofF. Liability And Medical Expenses OemnlUonabrrpteced by the following: (1) Liability arising oulol the wile negligence of the additional Insured; I2) "Bodily Injury",'propenY da me9•",'Pers"iff and advertising Injury"; defense verge 3. "Bodily Injury" means: archit a. under the Supplementay payment. section 91 the policy arising out of f an arcMtsC's, an, Bodily InJcary, 0i<kness, disease, ar Incidental medical tnalprectka Injury Sustained by a person, glnwtY or sumayor'stendering of a (allure to render any professional services InclutlIngt Including death resulting from any of these at any time. (A The Preparing, approving, Or filling to prepare or approve maps, shop drawings, opfn- K. AMENDMEN70F INSURED CONTRACT DEFINITION Ions, importer swvoys, field orders, change orders, adrawings and Specifications; and Paragraph 9. of P. Liability And Medical Expenses Definitions is replaced by the following: (b) Supervisory,Inspedidn,areMtecturelorenglAeerupeetivides. G. "Insured contract' means: (3) Any "Occurrence' that Likes place after you close to be a tenant In the premises described in e. A contract for a lease of psemises. However, that Portion of the Contract for a lease of premises the Declarations; or that fMemnifies any person or organization for damage by fire to premises while rented to you of (4) Structural eilalallons, maw construction or demolition operetlons performed by or for the temporarily occupied by you with Pefmiselon oliho owraeris not an 'Insured contract"; parson or organtratleen dotlgoslad In the Deetantlena. b. Aildeinckegreemenfl 3. Any coverage provided hereunder shall be excess over any other valid end eoffectibls Insurance avail- c. Any casement Of 11"1138 agreement, except In Connection with construction of demolition oper• able to the eddillonal Insured whether primary, excess, contingent or on any other bails unless a 10onson orwilhln60feelola railroad; contrail specifically requires that this Insurance be primary or you request that It apply on a primary basis. d. An obligation, es required by ordinance, to Indemnify a munkipaUty, except in connection with wort fora munkipality; VI. NEWLY FORMEDO C. Who OR An Insured: d: a. An elevator maintenance agreement; That-Ilowing Is added d to to S. An buss acquired by nsu I. That Pell Of any other contract or agreement pertaining to your business (Including en Irxlem. 9. Any business anUty by you or Incorporated or apard:ed by you Under the laws of any nificallon of a municipality In connection with worki,erlormed fora murJcip3lily)under whkhym ind[rldual stele of the United Slates of Amorlce over whkh you maintain majority ownership interest assume the tort liability of another party to pay for "bodily IMury" or "proporty damage" too killed exceeding fifty Percent Such acquired ot aowly formed Organization will qualify Sea Named Insured R person or organization, provided the "bodily Injury" or "property damage"Is caused, in whole of there Ism 11mllarinsurana ovallablelo that entity. However, in park. by you or by those meting on your behalf. Toil liability means a liability that would be a. Coverage under thla prevision Is elforded only unll the 110th day after the entity was acquired or Imposed by law In the absence of anycontratt or agreement. Incorporated or organized by you or the end of the policy period, whichever Is earlier; Paragraph f. door lack Include that part of any contractor agreement: b. Coverages A. Paragraph 1. Business Liability, does not apply to: (1) That lndii"Ifles a railroad for "bodily Injury" or "Property domage" arising out of construe. (I) "Bodily Injury" or 'propelty damage" that occurred before the en6ly was acquired or tracer- Don or demolition operations, within 501eet otany railroad property and effetUng anynllroed petaled or organtied byyou; and bi ldge or tvest!e, tracks, road-bids, tunnel, underpass or crossing; (21 "Peuonal and advertising Injury' Seeing out of an offense committed before the an111y was (2) That indemnifies an arehhec6 engineer or surveyor for Injury ordamage arising outof: acquired or Incorporated aorgwlsedby you, and (a) Preparing, approving, or (011109 to prepare or approve, maps, shop drawings, opinions, a, Recordsanddeacrlpllons of operations musk be maintained by the first Named Insured. reports, tumoys, field older/, change orders or drawings and Specifications; at No person or aganlzatIon Is an Insured with respect to the conduct of any current or post partnership, Ib) Giving directions or fottruc0ons, or falling to glye them, if that Is the primary cause of the Joint venture or limited liability company that Is not shown as a Named Insured in the Deoloradons. Injury or damalis; or VII. AGGREGATE LIMITS (3) Under which the Insured, It on architect, engineer, or eueyeyor, assumes IleblIty for en Injury or damage arising out of lye In ured'i rendering or failure to sender profenlonal cervices, The following Is added to Aggregate Limits Paragraph 4. of D. Llabnlly and MedFUI Expenses LIm1U of intludng those nsled In 171 above and Supervisory, Inspection, architectural or englu.'Ing Insurance: activities. The Aggregate Limits applyseparstety to each of "locations" ownedby orrentedlo you ortemporad[q XI. PERSONAL AND ADVERTISING INJURY occupied by you with the permisslon of the owner, paragraph 14, b. of F. Liability And Medical Expense s Definitions is replaced by the following: The Aggregate Limits aim apply separately to each of your projects away from premiso owned by or ranked to you b. Malicious prosecution or abuse of process. For the purpose of this endorsement only, "IocaUoq" means promises Involving the Same or concoct. Ing lots, or promisee whose Conoeglon Is Interrupted only by a 41reet, roadway, waterway or right. of•way of terellroad. hoe LIb" Muni eru*•n•. C-". M nmhu, nr.rral ea9A uses; a!utari h.-- Co,mpene. M re AY r.r.nrl 8P 79910809 Fdud.e wpvAos,.d m•t.d•lal 14-t- Oft-, tiro, tah its e•mledmi Fsge3 al4 BP 70900809 Aba.r•cvyrvN.J-aw•I ofI....eu S.M., Ore.. Ira.wMI. pt+Maebn Page 4 of4