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HomeMy WebLinkAboutInsurance Certificate: Portland Engineering ATE (MM/DD/YYYY) AC"R" ® P6/25/2015 CERTIFICATE OF LIABILITY INSURANCE 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 Kim Schnetzk NAME: y Ward Insurance Agency PHONE (541) 687-1117 FAX (541)342-6280 A/C No Ext : (A/C, No): _ PO Box 10167 E-MAIL kim@wardinsurance.net ADDRESS: INSURER(S) AFFORDING COVERAGE 'I NAIC # Eugene OR 97440 INSURERA:Cincinnati Specialty Underwriters 13037 INSURED INSURER B:Cincinnati Insurance -Companies Portland Engineering, Inc. INSURER C :Commerce & Industry Ins Co 7675 High Banks Road Suite 1 INSURERD:Continental Casualty_ Company INSURER E Central Point OR 97502 INSURER F: COVERAGES CERTIFICATE NUMBER:15/16 GL/AL/UMB /PROF/ POLL 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. INtO ADDL SUBR POLICY EFF POLICY EXP LTTYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS MME RCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR PREMISES O(Ea RENTED occur ence)_ $ 100,000 X { $1,000 BI/PD DED X Y CS00039055 7/1/2015 7/1/2016 MED EXP (Any one person) $ Excluded PER OCCURR PERSONAL & ADV INJURY $ 1, '000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 - - ~I POLICY X J PROJECT- L] LOC PRODUCTS - COMP/OP AGG I!i $ 2,000,000 OTHER: WA STOP GAP LIABILITY $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident) B ANY AUTO BODILY INJURY (Per person) $ ALL OWNED 7 AUTOS SCHEDULED AUTOS ENP0148589 7/1/2015 7/1/2016 BODILY INJURY (Per accident)' $ X NON-OWNED ~PROPERTY DAMAGHIRED AUTOS H AUTOS accident) I I X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB AGGREGATE _ $ 5,000,000 C DED RETENTION $ CLAIMS-MADE - EBU035625495 ! 7/1/2015 7/1/2016 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A - - (Mandatory in NH) E. LE. L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS oelow E.L. DISEASE- FOLICY LIMIT $ D (!PROFESSIONAL LIABILITY & MCH288379629 7/1/2015 7/1/2016 (LIMIT $2,000,000 POLLUTION LIABILITY DEDUCTIBLE $5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Ashland, Oregon and its elected officials, officers and employees are named as additional insured on a primary and non-contributory basis including waiver of subrogation and completed operations per the attached CSGA4031 & CSGA4087. Designated construction project(s) general aggregate limit applies per attached CG2503. All when required by written contract. All is subject to policy limits, terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE JJ M Holcomb/TRACES ~ © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) D C) PU to - :E m- m -i o m 3 m o o a N v N C~ m O T -I 'n -I N -O J m m -v - Qm m'v1 ~'mm`D~ o ° o- ~ oN ~'ac ~ N S a0 m m m cn m p _ ° N n c N O-O O ° m (D m o_ O o Z 77 3 z s= n c n D Z v o m -o m m a?. -mo o -oo ~n ul o a v m a o- y. n o- `D o n D = O 3o acflN~ m a m z (n 091 co oco N vm 2 oa"'m vo °c~Oa~oJ~2 z N O M ~N-OO z m _ _ odxm m a a~~aK_a,_ m z U) z ~Na~ e m n to J J N O N ? N `2 N O oa~~6N0~ ~o asp °aZ p z 0 r D o~o3- E E3 vycc cod Imo v~?v(~<a°~ U) o co ; z l z~ n to (A a O - N. 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