HomeMy WebLinkAboutInsurance Certificate: SOS Plumbing & Drain Service
F DATE (MM/DD/YYYY)
Acoac~ CERTIFICATE OF LIABILITY INSURANCE
Ilk 3/11/2016
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 have ADDITIONAL INSURED provisions or 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).
CONTACT
PRODUCER Brown & Brown Northwest N
AME: Susan Wilson
3256 Hillcrest Park Drive PHONE
Medford, OR 97504 ( A Lo, EXt): 541-494-2658 (A/c, No): 541-494 2758
ADDRESS: swilson@bbnw.com
INSURER(S) AFFORDING COVERAGE NAIC #
www.bbnw.com INSURER A : American Hallmark Insurance Company of Texas 43494
INSURED INSURER B :
SOS Plumbing & Drain Service Inc.
INSURERC:
206 South Pacific Highway
Talent OR 97540 INSURER D :
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: 28943823 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.
INSRADDLSUBR POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE IN SD WVD POLICY NUMBER MM/DDtYYYY MM/DD/YYYY
A ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ 44CL44337609 3/11/2016 3/11/2017 EACH OCCURRENCE S 1,000,000
DAMAGE CLAIMS-MADE / OCCUR PREMISES ~Ea oeaED nce) S 100,000
MED EXP (Any one person) S 5,000
PERSONAL s ADV INJURY S 1.000,000
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2.000,000
POLICY ✓ JE ~ LOC PRODUCTS - COMP/OP AGG S 2,000,000
OTHER S
A AUTOMOBILE LIABILITY 44CL44337609 3/11/2016 3/11/2017 COMBINED SINGLE LIMIT S
~Ea accident) 1,000,000
✓ ANY AUTO BODILY INJURY )Per person) S
OWNED SCHEDULED BODILY INJURY )Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident)
~ c
A ✓ UMBRELLA LIAB v/ OCCUR 44CU44337709 3/11/2016 3/11/2017 EACH OCCURRENCE S 1.000,000
EXCESS LIAB CLAIMS-MADE AGGPEGATE S 1.000,000
DED ✓ RETENTIONS 10,000 S
I '04CRKERS CCNIPr:NSAT, ION rEr- )Tu
AND EMPLOYERS' LiA.LML!TY YIN ST.',l UTE FP
ANYPR0PRIET0R/PARTNER,E:ECUTIVE E.L. E, _-H ACCIDENT S
OFFICER/M EMBER EXCLUDED" N/A
(Mandatory in NH) E.L DISEASE - EA EMPLOYEE S
If yes describe under
DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT S
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required)
General Liability coverage includes Blanket Additional Insured coverage including Prirrary/Non-contributory. Per Project Aggregate and Waiver of
Subrogation when required by written contract per attached endorsement MP97670408. Subject to policy terms, limits, conditions and exclusions.
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
Attn: Dale Peters ACCORDANCE WITH THE POLICY PROVISIONS.
90 N Mountain Avenue
Ashland OR 97520
AUTHORIZED REPRESENTATIVE
Susan Wilson 7-\1'
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ArnDn')c /~ntc/n~t Tk, ArnDn -411^-- t -1- -f Arnnn
ARTISANS ADVANTAGE ENHANCED COVERAGE ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
CAUSES OF LOSS - SPECIAL FORM
COMMERCIAL PROPERTY CONDITIONS
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
When this endorsement is attached to the policy, insurance under the Building and Personal Property Coverage Form, the
Causes of Loss - Special Form.. the Commercial Property Conditions and the Commercial General Liability Coverage Form is
enhanced to provide the coverages described in this endorsement. All other conditions of the policy continue to apply.
This coverage is subject to the provisions applicable to the Building and Personal Property Coverage Form. Causes of Loss -
Special Form, the Commercial Property Conditions and the General Liability Coverage Form.
SCHEDULE
Coverage Enhancements Limits of Insurance Each Location
Property Coverage Extensions
Newly Acquired or Constructed Property
Buildings $250.000. at Each Building
Business Personal Property $100,000. at Each Building
Personal Effects and Property of Others $ 10.000. at Replacement Cost
Valuable Papers and Records (Other than Electronic Data) $ 25,000.
Property Off-Premises (Including Laptops and Other Electronic Equipment) $ 10.000.
Outdoor Property (Named Perils) $ 1.000. per treejshrub, max. limit $15.000.
Non-Owned Detached Trailers $ 10,000.
Accounts Receivable $ 25.000.
Property in Transit (Including Laptops and Other Electronic Equipment) $ 10,000
Property Additional Coverages
Electronic Data $ 15.000.
Arson Reward $ 5.000.
Water Back-Up and Sump Overflow $ 25.000.
Business Income Including Extra Expense $ 25,000.
Inventory or Appraisal Cost $ 5.000_
Money and Securities
Inside $ 10.000.
Outside $ 5.000.
Ordinance or Law Coverage
Coverage A Included within Building Limit.
Coverages B and C Combined 25% of Bldg. Limit. $150.000. maximum
Outdoor Signs $ 5.000.
Recharging of Fire Extinguishers $ 5,000.
Inland Marine Coverages
Installation Coverage $ 10.000.
Contractors Equipment Coverages:
Small Tools $ 2.500. (Maximum limit per item $500)
Employee Small Tools $ 1.000 (Maximum limit per item $250)
Leased and Rented Equipment $ 5.000
Rental Reimbursement $ 1.000.
General Liabil Adgitionall Coverages
Blanket Additional Insured (Including Primary Non-Contributing Coverage) Included in Each Occurrence Limit
Mobile Equipment Broadened Coverage Included in Each Occurrence Limit
Aggregate Limit Per Project Included in Each Occurrence Limit
Blanket Waiver Included in Each Occurrence Limit
MP 97 67 04 08 Ind,,des copyrighted mater,a of ISO Prcper, es. Inc ano Paae 1 of 18
c. The following is added to A.2. Property Not Covered of the BUILDING AND PERSONAL PROPERTY
COVERAGE FORM:
r. Property while stored or operated underground in connection with any mining operations.
d. The following is added to Paragraph 2. of B. Exclusions of the CAUSES OF LOSS - SPECIAL FORM:
in. We will not pay for loss or damage caused by puncture. blowout and road damage to tires and tubes mounted on
vehicles. However, we do pay for puncture. blowout or road damage caused by a specified peril.
o. We will not pay for loss caused by humidity, dampness, dryness or changes in or extremes of temperature.
p. We will not pay for loss caused by the weight of a load which. under the operating conditions at the time of a loss.
exceeds the registered lifting capacity of any equipment or machine.
q. We will not pay for loss due to theft or mysterious disappearance from any vehicle or attached container. We
will pay for loss due to burglary when there are signs of forcible entry to a locked vehicle or container.
e. E.7. Valuation of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM is deleted and replaced by the
following:
7. Valuation
Vve wlll detei ,e o co a. in a_.e even" a Of i_.. d._i..__,... ..ge a..o l 1..ri......-.
lnine the value l'Opel(y (h O ions o UAila1 UVY
a. At actual cash value at the time of the loss (with a deduction for depreciation) except as provided in
paragraphs b. and c. following.
b. Pair or Set. The value of a lost or damaged article which is part of a pair or set is based on a reasonable
proportion of the value of the entire pair of set. The loss is not considered a total loss of the pair or set.
c. Loss to Parts. The value of a lost or damaged part of an item that consists of several parts when it is
complete is based on the value of only the lost or damaged part or the cost to repair or replace it.
2. Rental Reimbursement
In the event of loss by a covered peril to covered contractors' equipment that you own, we will reimburse you for your
expense to rent similar equipment while your equipment is inoperable. The most we will reimburse you for rental
reimbursement expenses is $1.000. We will continue to reimburse you for the rental of equipment after the expiration
date of this coverage provided the loss occurred before the expiration date.
We will not reimburse you:
a. If you can continue or resume your operations with similar equipment that is available to you at no additional
expense to you., or
b. For the rental expense of any equipment unless you make every reasonable effort to repair. replace or rebuild the
inoperable equipment after the covered loss occurs.
3. With respect to this Additional Coverage, Contractors Equipment Coverage, Section D. Deductible of the BUILDING
AND PERSONAL PROPERTY COVERAGE FORM is deleted and replaced by the following:
D. Deductible
We will not pay for loss or damage in any one occurrence until the amount of loss or damage exceeds $500 We will
then pay the amount of loss or damage in excess of $500 up to the applicable limit of insurance.
We will not reimburse you for the rental of equipment until after 72 hours have passed since the covered property
was rendered inoperable. After 72 hours have passed, we will only reimburse you for the rental expense that you
actually incur.
The deductible of $500 does not apply to rental reimbursement expenses.
General Liability Additional Coverages
The following Additional Coverages are added to the COMMERCIAL GENERAL LIABILITY COVERAGE FORM.
A. Blanket Additional Insured Coverage
1. SECTION II -WHO IS AN INSURED of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to
include as an insured any person or organization (referred to as Additional Insured) whom you are required to add as an
Additional Insured on this policy under:
a. A written contract or agreement: and
b. Where a certificate of insurance showing that person or organization as an additional insured has been issued: and
Page 14 of 18 Ind ides copyrighted marera' of ISO Properties, Inc. ano MP 97 67 04 08
c. When the written contract or agreement and certificate of insurance are currently in effect or becoming in effect
during the term of the policy and executed prior to the "bodily injury." "property damage," or "personal and
advertising injury."
2. The insurance provided to the Additional Insured is limited as follows:
a. The Additional Insured is only an additional insured for:
(1) "Bodily injury." "property damage," or "personal and advertising injury" caused in whole or in part by negligent
acts or omissions of the Named Insured or anyone directly or indirectly employed by the Named Insured or for
whose acts a Named Insured may be liable.
(2) Liability arising out of your ongoing operations for the Additional Insured by or for you. A person's or
organization's status as an insured under this coverage ends when your operations for that insured are
completed.
b. The Limits of Insurance applicable to the Additional Insured are those specified in the written contractor agreement
but not more than the Limits of Insurance specified in the Declarations for this policy. The Limits of Insurance
applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the
Declarations for the Named Insured.
3_ In addition to thr~ nther exclusions applicahie to Section I. Coverages A.. B. and C. of the COMMERCIAL GENERAL
LIABILITY COVERAGE FORM. the insurance provided to the Additional Insured does not apply to:
a. "Property damage" to.
(1) Property owned, used, occupied by, loaned or rented to the Additional Insured..
(2) Property in the care. custody or control of the Additional Insured or over which the Additional Insured are for any
purpose exercising physical control: or
(3) "Your work" performed for the Additional Insured.
b. "Bodily injury." "property damage," or "personal and advertising injury" arising out of an architect's, engineer's or
surveyor's rendering or failure to render any professional services for you, for the Additional Insured or for others.
including, but not limited to:
(1) The preparing, approving or failure to prepare or appprove maps. drawings. opinions, reports, surveys, change
orders. designs or specifications: or
(2) Supervisory, inspection or engineering services.
e. "Bodily injury" or "property damage" occurring after:
(1) 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 at the site of the
covered operations has been completed: or
(2) 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.
4. SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, is amended to add
the following subparagraph:
d. Additional Insured's Other Insurance As Excess Insurance
To the extent required by an "insured contract." this insurance is primary on behalf of the Additional Insured: and any
other insurance maintained by the Additional Insured is excess and not contributory with this insurance. If the
"insured contract" does not require this provision. then paragraph a. above will apply.
B. Mobile Equipment Broadened Coverage
VA 2.f.(1) of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is replaced by the following:
(1) Equipment designed primarily for:
(a) Snow Removal:
(b) Road maintenance, but not construction or resurfacing: or
(c) Street cleaning.
Except the above provisions do not apply to self-propelled vehicles of less than 1.000 pounds gross vehicle weight which
are not intended for use on a highway.
C. Aggregate Limit Per Project
The General Aggregate Limit under SECTION III - LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY
COVERAGE FORM applies separately to each of your projects away from premises owned by or rented to you.
MP 97 67 04 08 Inc ides copyrigh;ec ma;er,a of ISO Properl es. Inc anc Page 15 of 18
D. Blanket Waiver Of Transfer Of Rights Of Recovery Against Others To Us
The Transfer Of Rights Of Recovery Against Others To Us Condition (SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS) is amended by the addition of the following:
We waive any right of recovery we may have against any person or organization to whom you by written contract or
agreement have waived your own right or recovery for loss caused by that person or organization 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."
Additional Conditions
A. Insurance Under Two or More Coverages
The following is added to paragraph C. Insurance under Two or More Coverages of the COMMERCIAL PROPERTY
CONDITIONS:
If a Coverage Form is attached to this policv that provides a limit for arty coverage provided by this cr;dcrser, ent: the limit
shown in the SCHEDULE and the coverage provided by this endorsement are deleted and replaced by the limit and
coverage provided by the Coverage Form.
B. Limits of Insurance
Regardless of the number of buildings at a location covered by this endorsement, the most we will pay under this Coverage
Enhancement endorsement in any one occurrence is the applicable Limits of Insurance shown in the SCHEDULE on page 1
of this endorsement.
C. Deductibles
The Deductible described in section D. of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM applies to
each of the Coverage Enhancements except as shown below:
We will not pay for loss or damage in any one occurrence until the amount of loss or damage exceeds $500. We will then
pay the amount of loss or damage in excess of $500 up to the applicable Limit of Insurance for the following enhancements:
1. Personal Effects and Property of Others
2. Valuable Papers and Records (Other than Electronic Data)
3. Accounts Receivable
4. Property Off-Premises (Including Laptops and Other Electronic Equipment)
5. Outdoor Property (Named Perils)
6. Money and Securities
7. !0~_ ter Back-Up arid Sump Overf;ovv
8. Electronic Data
9. Property in Transit (Including Laptops and Other Electronic Equipment)
No deductible provisions apply to the following enhancements
1. Arson Reward
2. Recharging of Fire Extinguishers
3. Inventory or Appraisal Cost
4. Rental Reimbursement
D. Additional Definitions
The following Additional Definitions apply to this endorsement only.
1. "Banking Premises" means the interior of that portion of any building occupied by a banking institution or similar safe
depository.
2. "Business Income" means the:
a. Net income (Net Profit or Loss before income taxes) that would have been earned had no loss occurred. and
b. Continuing normal operating expenses incurred, including payroll.
For manufacturing risks. Net Income includes the net sales value of production.
Page 16 of 18 Includes copyrightec ma:er,a! of ISO Properi es. Inc arc MP 97 67 04 08
3. "Client" means an individual. company or organization with whom you have a written contract or work order for your
services for a described premises and have billed for your services.
4. "Employee" as used in Money and Securities coverage means:
a. "Employee" means:
(1) Any natural person:
(a) While in your service or for 30 days after termination of service:
(b) Who you compensate directly by salary, wages or commissions: and
(c) Who you have the right to direct and control while performing services for you:
(2) Any natural person who is furnished temporarily to you:
(a) To substitute for a permanent "employee" as defined in Paragraph (1) above. who is on leave: or
(b) To meet seasonal or short-term work load conditions:
while that person is subject to your direction and control and performing services for you, excluding, however,
any such person while having care and custody of property outside the "premises":
(3) Any natural person who is leased to you under a written agreement between you and a labor leasing firm, to
perform duties related to the conduct of your business, but does not mean a temporary employee as defined
in Paragraph (2) above:
(4) Any natural person who is your director or trustee while that person is handling "money" or "securities."
(5) Any natural person who is a former "employee," director, partner, member (an owner of a limited liability
company represented by its membership interest, who also may serve as a manager), manager (a person
serving in a directorial capacity for a limited liability company), representative or trustee retained as a
consultant while performing services for you: or
(6) Any natural person who is a guest student or intern pursuing studies or duties. excluding, however. any such
person while having care and custody of "money" or "securities" outside the "premises."
b. "Employee" does not mean:
(1) Any agent. broker. factor. commission merchant, consignee. independent contractor or representative of the
same general character or
(2) Any manager (a person serving in a directorial capacity for a limited liability company), director or trustee
except while performing acts coming within the scope of the usual duties of an "employee."
5. "Extra Expense" means necessary expenses you incur during the "period of reconstruction" that you would not
have incurred if there had been no direct physical loss or damage to property caused by or resulting from a Covered
Cause of Loss. Coverage pertains to expenses (other than the expense to repair or replace property) which are
incurred to
(1) Avoid or minimize the "suspension" of business and to continue "operations" at the described premises or at
replacement premises or temporary locations, including relocation expenses and costs to equip and operate the
replace, rent location or temporary location.
(2) Minimize the "suspension" of business if you cannot continue "operations."
6. "Finished Stock" means stock you have manufactured. Finished stock also includes whiskey and alcoholic products
being aged.
7. "Loss" as used in the Accounts Receivable Extension means accidental loss or damage
8. "Messenger" means you, any of your partners or any employee while having care and custody of the property outside
the "premises."
9. "Money" means:
a. Currency. coins and bank notes whether or not in current use: and
b. Travelers checks. register checks and money orders held for sale to the public.
10. "Occurrence" as used in the Money and Securities coverage means an act or series of related acts involving one or
more persons: or an act or event. or a series of related acts or events not involving any person.
11. "Operations" as used in the Business Income including Extra Expense coverage means your business activities
occurring at the address shown in the Declaration that you occupy for your business.
12. "Period of restoration" as used in the Business Income including Extra Expense coverage means the period of
time that:
a. Begins with the date of direct physical loss or damage caused by or resulting from any Covered Cause of Loss at
MP 97 67 04 08 InclAes copy,ighted mater,al of ISO Prcpet',es. Inc. anc Page 17 of 18
the described premises: and
b. Ends on the date when the property at the described premises should be repaired. rebuilt or replaced with
reasonable speed and similar quality.
"Period of Restoration" does not include any increased period required due to the enforcement of any ordinance of
law that:
(1) Regulates the construction, use or repair. or requires the tearing down of any property: or
(2) Requires any insured or others to test for, monitor, clean up. remove. contain. treat, detoxify or neutralize, or in
any way respond to. or assess the effects of "pollutants."
13. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot. fumes.
acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed.
14. "Premises" as used in the Money and Securities coverage means the interior of that portion of any building you
occupy in conducting your business.
15. "Premises" as used in the Accounts Receivable Extensions means that interior of the building at the address shown
in the Declarations that you occupy for your business.
16. "Securities" means negotiable a nd :10r1 neyot,uh!e ns try Ir?',,er:is or contracts representing either " money" or other
property and include:
a. Tokens, tickets, revenue and other stamps whether or not in current use: and
b. Evidences of debt issued in connection with credit or charge cards, which are not of your own issue but does not
include "money."
17. "Small Tools" means any tool which can be moved easily by one person without mechanical assistance and or can be
hand held for the purpose of doing labor.
18. "Suspension" as used in the Business Income including Extra Expense coverage means the slowdown or
cessation of your business activities.
19. "Temporary storage location" means a location where property that is to become a permanent part of a completed
project is stored while waiting to be delivered to the job site:
a. That you do not own, lease or operate: and
b. Where work is in progress. or will begin in 30 days.
20. "Theft" as used in the Money and Securities coverage means the unlawful taking of "money" or "securities" to the
deprivation of the Insured.
All Other Conditions of this Policy apply.
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