Loading...
HomeMy WebLinkAboutInsurance Certificate: Development Group Inc DEVEGRO-01 MARIAC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/23/2016 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 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: McDermott Costa Co., Inc. PHONE - 510 352-2731 arc, ~No : 510 3.5.2_-_8272 Cook Insurance Services A/c No Ex1~ _ _ ) E-MAIL _ 1045 MacArthur Blvd. ADDRESS: San Leandro, CA 94577 INSURER(S) AFFORDING COVERAGE NAIC # wsURER A : Massachusetts Bay Ins. Co. 22306 INSURED INSURER B : Allmerica Financial Benefit 41 4 Development Group, Inc. INSURER C : United States Liability Insurance Group P.O. Box 991484 INSURER D : Travelers Casualty & Surety Co - 19038 Redding, CA 96099-1484 INSURER E:-- 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. AD-D UBR~ POLICY EFF POLICY EXP I IL R TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) ! (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAB TOTED CLAIMS-MADE OCCUR X ODF-9891681-03 03/27/2016 0312712017 PREMISES (Eaoccurrence _ S - 300,000 MED EXP (Any one person) I S 10,000 PERSONAL & ADV INJURY _I S 1,000,000 rGEN L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 I POLICY PRO- ] LOC PRODUCTS-COMP/OPAGG I S 2,000,000 f J JECT - - t-$ _ OTHER COMBINED SINGLE LIMIT 000,,000 - - L - - AUTOMOBILE LIABILITY AWF-A137163 02 10/26/2015 Ea accident $ 1, - - B X ANY AUTO 10/26/2016 BODILY INJURY (Per person) S ALL OWNED SCHEDULED BI ODILY INJURY (Per accident) S AUTOS NON-AUTOSOWNED PROPERTY DAMAGE $ ~ f P_eraccident HIRED AUTOS _AUTOS ( ~ S - - - - EACH OCCURRENCE UMBRELLA LIAB OCCUR - - - S EXCESS ~ LIAB CLAIMS-MADE( AGGREGATE S DIED RETENTION $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY _ STATUTE_ _ ER Y/N', W2F-9891683-03 03/2712016 03/27/2017 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? i (Mandatory in NH) - N / A E L DISEASE -EA EMPLOYEE $ 1 ,000,000 If yes, describe under 1,000,00C DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT S C Tech Prof Liability TK1005543E 05/04/2015 1 05104/2016 ',Prof. Liability 3,000,000 D (Fidelity Bond 1106096234 0510112015 05101/2016 (,Third Party Coverage 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, Oregon, and its elected officials, officers and employees are named Additional Insureds for General Liability per 391-1006(0609) as respects work performed by the named insured. Insurance is primary and non-contributory per 391-1331(0609). Coverages shall not be cancelled except after thirty (30) days prior notice has been provided unless cancelled for non-payment of premium, then ten (10) days notice shall be given. 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 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Hanover insurance Group- ODF 9891681 5701148 BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SUMMARY OF COVERAGES Limits Page 1. Additional Insured by Contract, Agreement or Permit 1 2. Additional Insured - Broad Form Vendors 2 3. Alienated Premises 2 4. Bodily Injury Redefined 2 5. Broad Form Property Damage - Borrowed Equipment, Customers 2 Goods and Use of Elevators 6. Incidental Malpractice (Employed Nurses, EMT's and Paramedics) 3 7. Personal and Advertising Injury - Broad Form 3 8. Product Recall Expense $25,000 Occurrence $54,000 Aggregate 3 9. Unintentional Failure to Disclose Hazards 5 10. Unintentional Failure to Notify 5 This endorsement amends coverages provided under the Businessowners Coverage Form through new coverages and broader coverage grants, This coverage is subject to the provisions applicable to the Businessowners Coverage Form, except as provided below. 1. Additional Insured by Contract, Agreement or This insurance applies on a primary basis if Perrin that is required by the written contract, Under SECTION 11 - LIABILITY, C. Who Is An agreement or permit. Insured, Paragraph 4. is added as follows: b. This provision does not apply: a. Any person or organization for whom you (1) Unless the written contract or written are performing operations when you and agreement has been executed or permit such person or organization have agreed in has been issued prior to the "bodily writing in a contract, agreement or permit injury% "property damage" or "personal that such person or organization be added and advertising injury"; as an additional insured on your policy. Such (2) To any person or organization included person or organization Is an additional as an insured by an endorsement insured only with respect to liability for issued by us and made part of this "bodily injury", "property damage" or Policy; -personal and advertising injury" caused, in (3) To any person or organization included whole or in part, by: as an insured under Item 1.a.2. of this (1) Your acts or omissions; or endorsement; (2) The acts or omissions of those acting (4) To any lessor of equipment: on your behalf, (a) After the equipment lease expires; but only with respect to: or (3) "Your work" for the additional insured(s) (b) If the "bodily injury", "property at the location designated in the damage" or "personal and contract, agreement or permit; or advertising injury" arises out of the (4) Premises you own, rent, lease, control or sole negligence of the lessor; occupy. 391-1046 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 5 (5) To any: demonstration, testing, or the (a) Owners or other interests from substitution of parts under instruction whom land has been leased which from the manufacturer, and then takes place after the lease for that repackaged in the original container; land expires; or e. Any failure to make such inspection, (b) Managers or lessors of premises if: adjustments, tests or servicing as the (1) The occurrence takes lace after vendor has agreed to make or normally P undertakes to make in the usual course you cease to be a tenant in that of business in connection with the premises; or distribution or sale of the product; (iii) The "bodily injury", "property f. Demonstration, installation, servicing or damage" or "personal and repair operations, except such advertising injury" arises out of operations performed at the vendor's structural alterations, new premises in connection with the sale of construction or demolition the product; operations performed by or on behalf of the manager or lessor; g. Products which, after distribution or sale or by you, have been labeled or relabeled or used as a container, part or (6) To "bodily injury", "property damage" or ingredient of any thing or substance by " ersonal and advertising injury" u " arisin y g p 9 j rY 9 or for the vendor; or out of the rendering of or the failure to render any professional services. h• "Bodily injury" or "property damage" arising out of the sole negligence of the c. Additional insured coverage provided by vendor for its own acts or omissions or this provision will not be broader than those of its employees or anyone else coverage provided to any other insured. acting on its behalf. However, this d. All other insuring agreements, exclusions, exclusion does not apply to: and conditions of the policy apply. (1) The exceptions contained in 2. Additional Insured - Broad Form Vendors paragraphs 5.d. or 5.f.; or Under SECTION II - LIABILITY, C. Who Is An (2) Such inspections, adjustments, test Insured, paragraph 5. is added as follows: or servicing as the vendor has 5. Any person or organization with whom you agreed to make or normally agreed, because of a written contract or undertakes to make in the usual written agreement to provide insurance, but course of business, in connection only with respect to "bodily injury" or with the distribution or sale of the "property damage" arising out of "your products. products" which are distributed or sold in This insurance does not apply to any the regular course of the vendor's business. insured person or organization, from whom The insurance afforded the vendor does not you have acquired such products, or any apply to: ingredient, part or container, entering into, a. Bodily injury or property damage for accompanying or containing such products. which the vendor is obligated to pay 3. Alienated Premises damages by reason of the assumption of Under SECTION II - LIABILITY, B. Exclusions, liability in a contract or agreement. This paragraph 1.k-(2) is replaced in its entirety with exclusion does not apply to liability for the following: damages that the vendor would have in (2) Premises you sell, give away or abandon, if the absence of the contract or the "property damage" arises out of any part agreement; of those premises and occurred from b. Any express warranty unauthorized by hazards that were known by you, or should you; have reasonably been known by you, at the c. Any physical or chemical change In the time the property was transferred or product made intentionally by the abandoned. vendor; 4. Bodily Injury Redefined d. Repackaging, unless unpacked solely Under SECTION II - LIABILITY, F. Liability and for the purpose of inspection, Medical Expenses Definitions, definition 4. is replaced in its entirety by the following: 391-1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 5 HanF!yRr Insurance Group_ ODF 9891681 5701148 4. "Bodily injury" means bodily injury, (a) The insured; or disability, sickness or disease sustained by (b) Any officer of the corporation, a person, including death resulting from any director, stockholder, partner or of these at any time. "Bodily Iniury" includes member of the insured; and mental anguish or other mental injury (2) Not directly or indirectly related to an resulting from "bodily injury". 11 5. Broad Form Property Damage - Borrowed employee", nor to the employment, prospective employment or termination of Equipment, Customers Goods, Use of Elevators any person or persons by an insured. a. Under SECTION II - LIABILITY, B. 8. Product Recall Expense Exclusions, paragraph 1.k., the following is added: a. Under SECTION II - LIABILITY, B. Paragraph (4) does not aPPIY to "property Exclusions, Paragraph 1. o. is replaced in its entirety by the following: damage" to borrowed equipment while at a jobsite and not being used to perform o. Recall of Products, Work or Impaired operations. Property Paragraph (3), (4) and (6) do not apply to Damages claimed for any loss, cost or "property damage" to "customers goods" expense incurred by you or others for while on your premises nor to the use of the loss of use, withdrawal, recall, elevators. inspection, repair, replacement, b. Under SECTION II - LIABILITY, F. Liability adjustment, removal or disposal of: and Medical Expenses Definitions, the (1) "Your product"; following additional definition is added: (2) "Your work"; or "Customers goods" means property of your (3) "Impaired property"; customer on your premises for the purpose If such product, work or property is of being: withdrawn or recalled from the market a. Worked on; or or from use by any person or b. Used in your manufacturing process. organization because of a known or suspected defect, deficiency, inadequacy c. The insurance afforded under this provision or dangerous condition in it, but this is excess over any other valid and exclusion does not apply to "product collectible property insurance (including recall expenses" that you incur for the deductible) available to the insured whether "covered recall" of "your product". The primary, excess, contingent or on any other exception to the exclusion does not basis. apply to "product recall expenses" 6. Incidental Malpractice - Employed Nurses, resulting from: EMT's and Paramedics (1) Failure of any products to Under SECTION II - LIABILITY, C. Who Is An accomplish their intended purpose; Insured, paragraph 2.a.(1)(d) does not apply to a (2) Breach of warranties of fitness, nurse, emergency medical technician or quality, durability or performance; paramedic employed by you if you are not (3) loss of customer approval, or any engaged in the business or occupation of cost incurred to regain customer providing medical, paramedical, surgical, dental, x-ray or nursing services. approval; 7. Personal and Advertising Injury - Broad Form (4) Redistribution or replacement of Under SECTION II - LIABILITY, F. Liability and "your product" which has been recalled by like products or Medical Expenses Definitions, definition 15, substitutes; "Personal and Advertising Injury", paragraph h. is added as follows: (5) Caprice or whim of the insured; h. Discrimination or humiliation (unless (6) A condition likely to cause loss of insurance thereof is prohibited by law) that which any insured knew or had results in injury to the feelings or reputation reason to know at the inception of of a natural person, but only if such this insurance; discrimination or humiliation is: (7) Asbestos, including loss, damage (1) Not done intentionally by or at the or clean up resulting from asbestos direction of: or asbestos containing materials; or 391-1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 3 of 5 (8) Recall of "your products" that have printed advertisements including no known or suspected defect stationary, envelopes and solely because a known or postage; suspected defect in another of (2) Shipping the recalled products "your products" has been found. from any purchaser, distributor b. Under SECTION 11 - LIABILITY, C. Who or user to the place or places Is An Insured, paragraph 4.c. is added designated by you; as follows: (3) Remuneration paid to your c. "Bodily injury" or "property damage" regular "employees" for do not apply to "product recall necessary overtime; expense" arising out of any (4) Hiring additional persons, other withdrawal or recall that occurred than your regular "employees"; before you acquired or formed the organization. (5) Expenses incurred by employees including c. Under SECTION 11 - LIABILITY, E. transportation and Liability and Medical Expense General accommodations; Conditions, 2. Duties in the Event; of Occurrence, Offense, Claim or Suit, (6) Expenses to rent additional paragraph e. is added as follows: warehouse or storage space; e. You must see to it that the following (7) Disposal of "your product", but are done in the event of an actual or only to the extent that specific anticipated "covered recall" that methods of destruction other may result in "product recall than those employed for trash expense": discarding or disposal are required to avoid bodily injury (1) Give us prompt notice of any or "property damage" as a result discovery or notification that of such disposal, "your product" must be withdrawn or recalled. Include a you incur exclusively for the purpose description of "your product" of recalling "your product"; and and the reason for the b. Your lost profit resulting from such withdrawal or recall; "covered recall". (2) Cease any further release, e. Under SECTION II - LIABILITY, D. shipment, consignment or any Liability and Medical Expenses Limits of other method of distribution of Insurance, the following is added: like or similar products until it 5. The Limits of Insurance and rules has been determined that all stated below fix the most that we such products are free from will pay under this Product Recall defects that could be a cause of Expense Coverage. loss under this insurance. (1) The Aggregate Limit is the most d. Under SECTION II - LIABILITY, F. that we will reimburse you for Liability and Medical Expenses the sum of all "product recall Definitions, the following additional expenses' incurred for all definitions are added: "product recall expenses" "Covered recall" means a recall made initiated during the policy period. necessary because you or a government (2) The Occurrence Limit shown on body has determined that a known or the Summary of Coverages is suspected defect, deficiency, the most we will pay in inadequacy, -or dangerous condition in connection with any one defect "your product" has resulted or will result or deficiency. in bodily injury" or property damage". " (a) All It product recall "Product recall expense(s)" means: expenses" in connection with substantially the same a. Necessary and reasonable expenses general harmful condition for: will be deemed to arise out (1) Communications, including radio of the same defect or or television announcements or deficiency and considered one "occurrence". 391-1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 5 Hanover Insurance Group_ ODF 9891681 5701148 (b) Any amount reimbursed for "product recall expenses" in connection with any one "occurrence" will reduce the amount of the Aggregate Limit available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. (c) If the Aggregate Limit has been reduced by reimbursement of "product recall expenses" to an amount that is less than the Occurrence Limit, the remaining Aggregate Limit is the most that will be available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. 6. A deductible of $500 applies per each "Occurrence". 9. Unintentional Failure to Disclose Hazards Under SECTION II - LIABILITY, E. Liability and Medical Expenses General Conditions, paragraph 6. is added as follows: 6. Representations We will not disclaim coverage under this Coverage Form if you fail to disclose all hazards existing as of the inception date of the policy provided such failure is not intentional. 10. Unintentional Failure to Notify Under SECTION II - LIABILITY, E: Liability and Medical Expenses General Conditions, 2. Duties In the Event of Occurrence, Offense, Claim or Suit, paragraph C is added as follows: f. Your rights afforded under this Coverage Form shall not be prejudiced if you fail to give us notice of an "occurrence", offense, claim or "suit", solely due to your reasonable and documented belief that the °bodily injury" or "property damage" is not covered under this Policy. 391-1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 5 of 5 Hanover Insurance Croup- OD F 9891681 5701148 OTHER INSURANCE - PRIMARY AND NON-CONTRIBUTORY (ADDITIONAL INSURED) ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to SECTION III - COMMON POLICY CONDITIONS: M. Other Insurance (b) That is Fire insurance for 1. Additional Insureds premises rented to the If you agree in a written contract, written Additional Insured or agreement or permit that the insurance temporarily occupied by the provided to any person or organization Additional Insured with included as an Additional Insured under permission of the owner; SECTION II - LIABILITY, Part C - Who is An (c) That is insurance purchased by Insured, is primary and non-contributory, the Additional Insured to cover the following applies: the Additional Insured's liability If other valid and collectible insurance is as a tenant for "property available to the Additional Insured for a loss damage to premises rented to we cover under SECTION II - LIABILITY, the Additional Insured or Part A. Coverages, Paragraph 1., Business temporarily occupied by the Liability our obligations are limited as Additional Insured with follows: permission of the owner; or a. Primary Insurance (d) If the loss arises out of the ry maintenance or use of aircraft, This insurance is primary to other "autos" or watercraft to the insurance that is available to the extent not subject to Exclusion g. Additional Insured which covers the of SECTION II - LIABILITY, Part Additional Insured as a Named Insured. A. Coverages, 1. Business We will not seek contribution from any Liability. other insurance available to the When this insurance is excess, we will Additional Insured except: have no duty under SECTION II - (1) For the sole negligence of the LIABILITY, Part A. Coverages, 1. Additional Insured; Business Liability to defend the insured (2) When the Additional Insured is an against any "suit" if any other insurer Additional Insured under another has a duty to defend the insured against primary liability policy; or that "suit". If no other insurer defends, we will undertake to do so, but we will (3) When b.(2) below applies. be entitled to the insured's rights If this insurance is primary, our against all those other insurers. obligations are not affected unless any When this insurance is excess over of the other insurance is also primary. other insurance, we will pay only our Then, we will share with all that other share of the amount of the loss, if any, insurance by the method described in that exceeds the sum of: b.(3) below. b. Excess Insurance (2) The total amount that all such other insurance would pay for the loss in This insurance is excess over: the absence of this insurance; and (1) Any of the other insurance, whether (3) The total of all deductible and primary, excess, contingent or on self-insured amounts under all that any other basis: other insurance. (a) That is Fire, Extended Coverage, We will share the remaining loss, if any, Builder's Risk, Installation Risk with any other insurance that is not or similar coverage for "your work"; 391-1331 06 09 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 1 of 2 described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 391-1331 06 09 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 2 of 2