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HomeMy WebLinkAboutInsurance Certificate: Peck Smiley Ettlin Architects DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/19/2016 THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED, subject to the terns 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: BROWN & BROWN NORTHWEST/PHS (AIC,No,Ext): (866) 467-8730 (AI ,No): (888) 443-6112 709437 P: (866) 467-8730 F: (888) 443-6112 ADDRESS: PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC#F SAN ANTONIO TX 78265 INSURER A: Hartford Casualty Ins Co INSURED INSURER B : PECK, SMILEY, ETTLIN ARCHITECTS INC. INSURER C: NED PECK, STEVE SMILLEY, & HANS ETTLIN INSURER D: 4412 SW CORBETT AVE INSURER E: PORTLAND OR 97239 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. EVER TYPE OF INSURANCE ADDL SUBR POLICYNUMRER POLICY EFF POLICYEXP LIMITS DD/)TYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s2,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED 5 300,000 PREMISES (Ea occurrence) A X General Liab x 52 SBA UL7992 04/01/2016 04/01/2017 MED EXP (Any one person) $10,000 PERSONAL a ADV INJURY s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4,000,000 POLICY I PRO ❑ LOC PRODUCTS - COMP/OP AGG s4,000, 000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s2,000,000 (Ea accident) ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED 52 SBA UL7 9 9 2 04/01/2016 04/01/2017 BODILY INJURY (Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ S X UMBRELLA UAB X OCCUR EACH OCCURRENCE $1, 000, 000 A EXCESS LIAB CLAIMS-MADE 52 SBA UL7992 04/01/2016 04/01/2017 AGGREGATE $1,000,000 DE X RETENTION s1.0 , 0 0 0 $ PER OTH- fPORKERS COMPENSA7TON AND EMPLOYERS LrABLUTY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEY/N E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? WA (Mandatory in NH F1 ) E.L. DISEASE- EA EMPLOYEE $ If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS / VEHIC(AMORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. a i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED of Ashland, It's Officers BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE City o DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Employees, and Agents. AUTHORIZED REPRESENTATIVE Y 20 East Main Street Ashland, OR 97520 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD