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HomeMy WebLinkAboutInsurance Certificate: Quality Fence Co Reliable Electric QUALFEN-01 ATHOMPSON ACOR'ID.• CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/26/2016 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: McMinnville Office PHONE FAX Paynewest Insurance, Inc. A/c No Ext : (503) 472-2121 (A/C No : (503) 434-5872 P.O. BOX 269 E-MAIL ADDRESS: McMinnville, OR 97128 INSURERS AFFORDING COVERAGE NAIC # INSURER A : Hallmark Insurance Group 43494 INSURED INSURER B Quality Fence Co Reliable Electric Western Vinyl Products INSURER C : Steve Rietmann INSURER D : PO BOX 3985 INSURER E : Central Point, OR 97502 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN D WVD POLICY NUMBER MM/DDIYYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR X X 44CL466835 11119/2015 11/19/2016 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ~ JE ~ F~ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A X ANY AUTO X 44CL466835 11/19/2015 11/1912016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAR CLAIMS-MADE 44CU466836 11/19/2015 11/19/2016 AGGREGATE $ DED X RETENTION $ 10,000 3,000,000 $ WORKERS COMPENSATION PER 5TH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Commercial Property 44CL466835 11/1912015 11/19/2016 leased eq 25,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) City of Ashland is additional insured as respects liability arising out of the activities by and on behalf of the named insured per attached endorsements. 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 Y ACCORDANCE WITH THE POLICY PROVISIONS. 90 N Mountain St 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 POLICY NUMBER: 4 4CL4 6 6 8 3 5 COMMERCIAL GENERAL- •LIASILITY GC 10,2507 09 f - THIS ENDDRSEMENT:GHANG)5S THE- PDLICY.:PLEASE. READ.IT-CAREFULL.•Y;': j - • O i~CQ> '::>ALA:,ILK -8 . ' D-DIT1a C.AL"IIVS U>R D ; ; M ° DOMPLETED':UPERA`1'IONS • • . •'t ' This endorsement modifies Insurance prodded underthe following; . COMMERCIAL GENERAL LIABILITY.COVERAGE PART; _ 'A. • Section 11-• Who IsAn`Insd ed'is-amended to include•as•an•addttlonal Insured.any, person Qr;organization = for whom you are:perfomIng.,operations.when you and-sych persgn,or.organizatlon•have•agreecl•In writing In I a contract or agfdsment•thaf.such'person or oiganization•be- added-as an additional Insured•for:completed - . , . . operations: Such person-or-organization Is•an-additional Insured only to.the extentthat.the Ifabilltyfor "bodily.. Injury, or "property damage" Is caused, In whole or In-part, by "your work" performed for that addltlonal•an- • sured and Included In the "products-aompleted operations .hazard.", B. With respeot to the Insurance afforded -to thesa addltlonai Insureds, the following limitations apply.'; 4. 'This additional Insured status•is granted only at the locations listed In the written contract. 2. Coverage is-limited to !'your work'that is described-in the classifications or schedule of hazards shown -in • the General Liability Declarations of this policy. , -C. With respect to the insurance afforded- to these additional. insureds; the following exclusion applies:. - This Insurance does not apply to: "Bodily Injury" or "property dalmage" Which occurs prior to the.execution of the wriften contract or the effec- . . tive date of this endorsement. I t f f 1 GC 10 25 07 09 Includes oopyrighted material of Page 4 of 1 [I • .Insurance Servloes Office, Inc., wX11 Its permisslon l ARTISANS AWANT'A091~MANMID COVERAGE ENDQJ3S 4MVT ' THIS ENPQRSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, This pndorsementmod►fles )nsgrance prQvlded under the tpl)oYAniv BUlLp1NQ A11iA PN2RSb1VAL pNQPER7~Y CoVEaARE FORM , CAUSES OF•LgRS-- ppgiAL P'O,RM ; , , COMMERCIAL PROPERTY 66N6tbo1v5 , ; COIF MERC(AL g5fmdli ' LIA&17t CdV9M. CAE FORM . , ' . lb. When this-Ewddrseme'n' is attaohed fo•'the.poll❑y, Insurance under the Building and Psrsonal'Properly Cdverage`Form,Ahe- Qauses ❑f Loss Speo)al Form, the Commero)al Prvporty. CConditions and the Commerala) 131aneral•1labllity O❑uerage Fprm Js, ' enhanosd to pr4vlde the aoverpges desorlbsd.In this endoreemBnt. All other oonditlons oftht3 polfoy.oont)nue to apply. , , • . .7'his.aoveraga Js eub)eotto..the l?r9Y~slans•spplloab)p.ta,th~ 13u)Id)ng.arrd P,ers❑nal l'r❑perty.Covergge.Forrn,•C~uses,of L•..pss . , ' ' Special Form, the Commerdial Properly Conditions and the i2efiera) LJabliftj, Coverage rormr, • , SGHcl7ULB ' Coverage lrnhanoemants Limits of Insurance lraah Loaefion Ntap-ob,~ dysYacle cxtertstgns . ' • wly Acquired or Oonstruoted Properly ' Br lldJngs $250,000, at Each Bu1)ding..; Busimas Personal Properly' $100,000. at Eaoh Btalldlpg • Personal Effeatd and Properg+ of Others $ 10,000. at Replaoexnant Cast r Valuable Papers and Records (Mar tJian Eledtronlo Data) $ 26,000. . property, Off-Premises (1hclWing Lpptpp's and Other Eleetronlo Rqulprnent) $ 10,000. • • - • , Dutdoor Property (Named Perils) $ 9,000. pertree/shrub,'rna~. Ilm1tg.15,o00. Non-Owned Detached Trallers 0,000. Accounts Aecelvable $ 26,00()• Property in Transit (including Laptops and Other Electronic Equlpment) $10,000, Property Addttianal Ooyerages ' Eleotronlo Data $ 15,000, , Arson Reward $ 510001 Water Baok Up and Bump Overflow $ 25,000. . • I Business Income Including Extra Expense $ 26,0D0, I Inventory or Appralsal Cost $ 6,000. Money and 5eoudlies - 1 i tittt inside $ 10,000. I It. Outside $ 5,000, i Ordinance or Law Coverage t i Coverage A Inoludedwfthin Building Limit. Doveragas B and C Combined 28% of 13tdg. Limit, $46o,oo0. maximum outdoor Signs $ 6,000, j Recharging of Firs Extinguishers r~ 510001 Inland Marine Co4araaes. Installablon Coverage Contractors Equipment Coverages t Small Tools $ 2,5013, (Maximum XMIt Pei, Item $500) I ° Employee SmallTaa)s $ 1,000, (Meurlmum J1Mltper)te.M TgE;Q) Leased and-Rented Fqu)pment $ 5,000, . , i Rental Reimbursement $ 1,000• - t. .General Ltabtfity Additional Coverages • Blanket Additional Insured (Inaluding Primary Non-ContrlbUling Co0rage) Included In Eaah 0Qaurrenoa,Qrnjt Mobile Equipment Broadened Coverage Ino)udsd In Eaph OppurrsnDa L.Im(t. Aggregate L1mlt Per Prajeot Included In Each Ocourrencla Limii; Blanket Walver Inoludad`In each Poqurrsnoe Limit , . MP 97 67 04 oB Ipoludes mpyrlahted mzt4z) of ISO ProperAes, Ino, end Page I of 1.9 • •AmedoonAsaoolMon oflnsuranos Bend=, Ino.,used with Their parmlaslan i ' ' r y ' c. The following Is added to A,2, Propelty Not Covered of the BUILDING AND PERSOIIAL PROPERTY COVa AGE FOPM; r. Prgperty while stored or operated underground in ponneatlon with any mining operatlons, d, The following Is added to Paragr@ph 2. of B. Excluslw7s of the CAUSES OF LOi$s , SPECIAL rQRM: n. We will notpgfprJoss ardama®e caused by puncture, blowoutand road dampgp'to 1:lree and tubes mounted on I vehicles, H*sver, -we do pqy for puncture, blo%6ut or road damage caused by a specified peril. • o, Ws will not payforloss caused by humldlty, dampness, dryness or ohanges'in or extrpm@s r?f temperature, p, We will not payforloss caused bythe weight of a Jo@d which, under fhe operating cDWIVons atthe time ofa loss, , axoeeds the reglsterad )lftlnq.oapacity, of anj, eg4lpme6i or machine. q.. Wemlll notpayfor losp due,to-thsft or mysterious disappearenoetrnm any vehicle or attaohed,gontaID6;. We• : ! will pqy for•loss due to burglary when there are signs of farolble entry to a Iool(ei d vehicle or contalner, • , •e, 13,%ValuatlonaftheBUILDJNGAND. PERSONAL PROPERTY 0QUF.AAQEFORM Jsdeleteda rpplaced,bythe following: - 1 7, Valuation We will determine the value of covered property In the event of loss or damage as follows: , a. At actual bash value at the time of the loss (whh a deduatlon for depreciation) except as proylded•ln • ' ' . • paragraphs b, and c. following, ' b, Palr or set, The value of a lost or. damaged artlols wh)ch if; part of s •palr ar set Is.based on a reasonable • proportion ofthe value ofthe entire pair ar set, The loss Is not considered a tatat 11388 of the pair Pr sat,' 'o; Loss to Parts:7he value of a lost or damaged part of an Jtem Thal nonalste of several parts when Ji is complete Is based on the value of only the lost or damaged part or the cost to repair or replace It, 2, Rental Reirabu'rsprnent ' In the event of loss by a covered peril to covered contractcrs' equipment that you own, we will reimburse .yQu.far your expense to rent similar equipment while your equipment Js inoperable : The rnost we will reimburse yda f6r-rental relmborsement expenses Is $11000: We will continue to reimburse you forthe rental of equipmentaftsr-fhe expiration date of this coverage provided the loss occurred before the explratfon data, We will not reimburse you: s, it you can continue or resume your operations with similar equipment that Is. available to you at no additional expense to you; or b. Forthe rental expense.of any equipment unless you make every reasonable effortto repair, rep)aos or rebuild the inoperable equipment after the covered loss occurs, 6. With respect to this Additional Coverage, Cori actors Equipment Coverage, Seotlon D, Deduelbie orthe BUILDING ARD PFRSoNAL PROPERTY COVERAGE FORM is deleted and replaced bythe following: , l D. Deductible ' We will nDtpay for lbw or damage in any one occurrence until the amount of loss or damage exceeds 8500. We wJIi ~ then pay the amount of loss or. damage In excess of $50D up to the applicable limit of insurange, % .1 7 We will not reimburse you for the rental df equipment until after 72 hours have passed since the covered property was rendered Inoperable, After 72 hours have passed, we wig only reimburse you fol•the rental expense that you actually Incur. The deduotlble of $600 doss not apply to rental reimbursement expenses, GeneraIldabllityAdditlorral Coverages , 1 I The following Additional Coverages au'e added to t e CDMM&RCIAL CENP-BAL. JABILITY COVERAGE FORM. A. EfanketAdditional Insured Coverage 1. SECTION P- WHO IS ANINSURI;A offho COMMERCIAL Q12NBI3AL LIABILITY GOVERAQE FORM is amended to, )noluds As an insured any person or organization (referred toad Additional Insurer) whom you are requlradto add qs an Addlllcnal Insured on this policy under; • . . , ' , • a, A written contract or agreement; and , b, • Wheraaoerttfloate'oflnsuranosshow)ngthatperaon ororganlzafion as an additional lnsuFad has bean Issued; and Page 14 of 1B Inoiudesmpyrlghted malenal oflso Properties, Inc, and MP 97 67 04 a8 Amerlc4n laaoolallan of Insurance 88tV1Dea, Inc; used wlrh ibelr permiselorn a. when the written contract Di' agreement and certifioate of Insuranoe are currently In effect: or bsoomlpg In eftpot during the term of the policy and exeoulpd-.prior to the "bodily In)ury," "prooperty damage," or "personal; and advartising in)ury" i The Insuranoe prpvlded to the Additional insured Is ltmited ag followp: a. The Additional Insured Is only an addifional Insured for (1) 113odiV Injury,' "property damage," or''psrsonsl and a~verttsing injury" caused In whole o1• In part by negligent ,acts or omissions bfthe Namiad Insured oranyone.dlrectly or lndlrentty omployed by, the Named Insured orfor • whose sots a Named inured may be liable, " ' (2) Llablllty arlsing out of your o6galr7g tPpHratlons for the Additional Insured by or for you. A. person's pr ' orgsnlzatlon's status as an Insured •under ih* coverage ands when your opprgtlons for that Irtsurso are • completed: ' , . Is. The Llmlt's of insurance applicable fo'the Additionar inqurea are those speolfled In the wrdtpn contract oragreement w f]eBlarallons for.this•polloy, The Limlis,of,lnsuranoe • ' . -but not more than the•i.lmits-❑f•insutance:specitled ln-tha:• . ' applicable to the Addltlonai lnsur(ad'are Inclusive of and not in add )on to the LImlts of Insuranoe shown in the Declaratlons forthe Named Insurer(, 3. In addition to the otherexoluslons applicable to 9ed9orIJ,. Coverages A., B. and C. af#hs c p1Vt~ t3CIAL aENERAL LIABILITY COV RAQ9 FORM, #is Insuranoe provided to the Ad¢!tlonal insured does not x 1 • a: • - a, "Property damage"to, . (f) Property owned, used, occupied by, loaned or rented to the Additional Insured; (2) Property in Me oars, custody or control of the Additional Insured orover,•whtoh•theAddttlonal.Insurpd are for any , purpose exerolsing physloal control; or (3) "Your work". performed for the Additional Insured; ' b. "Bodlly Injury," "property damage," or "personal and adverflsing injurf arising out of an•arahltect's, en¢inssr's or surveyor's rendering orfallure•to render any professlonal sarv)oes foryou, for the Addlfional Insured or for-others, . • including, but not limited lo: - (•t) The preparing, approving or failure to prepare or approve maps, drawings, oplhiona, reports, survays, change - orders, designs or speolfloatlons; or • ' (2) Supervisory, Inspection or engineering servicea, , a, "Bodily Injury" or "property damage" acourring after, ('I) Ali work, Includingmaterlals, parts or squlpment:furnlehed In connection with such worlt, on the projeot (other than uarvloe, maintenance or repairs) to be performed by or an behalf of the additional Insured atthe site of the covered operallons has been completed; or (2) That portion of "Irour worts" a ut of which the injury or damage arises has been put to its intended use by any person or organlzatlon othertfian another oontractor or subcontractor engaged in performing operations Tor a principal as a pad ofthe Samaprojsoi. 4. Si:CT1ONIV-CDMMERCIALgEI45RALLIABILITYCCNE31TJONS,paragrapbA.Other insurance,4samendedtoadd - . the following subparagraph: d Additional Insured's Other Insuranae As Exoess Insuranoe To the extent requlradby an "Insured oontraot,"this Jnsurance Is primar rcn behalf ofihe Additional Insured; and any other Insuranoe maintained by the Additional Insured Is exosss and not contributory with this Insurance, If the; "Insured contract" does not require this provision, then paragraph a, above will apply, 13. Mobile Equipment Broadened Coverage - 1I,121('f) ofthe COMMERGJAL QENERAL. LIABIL. TY COkrERAGE FORM Is replaced by the foilow}nIr (1) Equipment designgd primarlly for: • - • -(a) Snow Removait : - • • (b) Road maintenance, but not construotlon or resurfacing; or ' , • is J. M ' • (a) Street cleaning ' Excaptths above provlelowdo notapply to self propelled ve111910 of less than 1,D00 pounds gl-oas vehlale welghtwhioh : •ti • are not Intendad for use on a highway • 'C. Aggroquis imltPer pro)aot t • The Qeneral AgdragateLlmftuitder SECT1011Ill -'LIMIT8'4F.1NS1JftAJ40E ofthp C0MMERCriALC3EN9RAL LIABILITY, • COVERAGE FORM applies separately to each of Your projects awayfrom premisas Owned by or rented tn,you.. . • . MP 97 67 04 08 lnaludes copyrighted materlal of 160 Pmperlles, Inc, and page 15 of'1 AmetioanAecccl9lian oflnsuranoe 9aroloes, Inc,, used vWlh Iheirpsrmisslan ' i i I D. Blanket Waiver Of Transfer of Rights of Reoovery Against others To Us The Transfer of Rights 0f Fleafluery •Agal6st Others To Us Oondhion (SECTION IV 001141S RC1AL QE WIERAL LIABILITY PONVIT)OM)'ls amended by the addiibn of4he fpl)owln9; . . ' M.Walve any right:df recovery We *May have against any,person or croanJzaWn to whom you by wr*n contract or agroementhave waiwadyourrnvn rlghtprreooveryforloaecaused bythptperson orprganlzatioft bpctzuae pfpaym nts we . ' - : make for Injury or damage atlslhd orat of your ongoing operailohe nr''your worlt" done under a Qontra6, with that person on• organlzatloti and Included In the "products-compldted operations hazard," r . ContJlilors r Additional - A. Insurance 0nder.Tiyo or More Coverages fi he foflow)ng )s'added to pat'agraph'C. Insurance under-`T`wa,or'llllore Eoverages of the•COHNERCIAL PROPgR- TY • , coNt.11TIONS: . If a Coverage Form-Is aftchedtp this policythatprovldes a Ilmirforany coverage provided by.-this endorsement; the limit. shown in the SCHEDULE and the ooverage predided lay this endorsement are deleted and replaced by the'llmfi and coverage provided by the Coverage, Form. B. Limits citInsurance Asgardless of the nurI or Aulldings at a looatlon ooveted'by this endorsement, the mostwe will pay underth)s Oov$rage Enhancement endorsement In-any one eoourrenba Is the applicable Limits of Insurance shown in the'SCHEDULS on page I , of this endorsement, ' Deductibles I he Deductible descH ed In seotion D. ofthe BUILDING AND PERSONAL PROPPETTY COVERAGE rORIUI *pile,,!- to • . • each of the Coverage Enhancements except as shown belovv► T . We will notpayfor loss or damage In any one occurrence until the amount of loss or damage exceeds $50D. W$ will th4n pelythe amount of loss ordamage In excess of$500 upto the applicable Limit of Insuranoeforthe following enhancem erlts; . 'I. Personal Effects and Property of Others 2- Valuable Papers and Recorda (Other than Elsotronlo Data) 3, Aooounts Receivable 4. Property Olt Premises (Including Laptops and Other Electronic Equipment) t B. Outdoor Properly (Named Perlis) = 8, money and Securities e,\ ° 7. Water Back Up and Sump Overflow S. Electronic Data . 91 Properly In transit (Including Laptops and Other Electronic Equipment) ' • No deductible provisions applyto the tolicvylng enhancements::. 1. Arson Reward • 2. Recharging of Fire Exdngulshers 3, Inventory or Appraisal Cost I 4. Rental Reimbursement • ' ' D, Addition( Ddrilfions The following Additlonal DsNiilons spplyto this endorsement only: , ' 7, 'rBanldng Promisee" means the )ntertoroftf iatportlon of anY bulfdhlg obouplad by akaTlkltl9Inat(tutIon or elmllar safe ° , ' depository. ; . , 2, "Business Income" means the,, a. Nq~.lpgomq (Nat Prpo or,Lou before Income -taxes) that would hive been earned had no loss Dcpurred4 and ; , . b, CQntlnuing normal operating expenses Inourred; lnoluc ng-payroll. , For manufacturing risks, Not Income Includes the net sales value of production, Page 16 of 18 Includes copyrighted malarial or wo Properties, inc, and MP 97 67 04 08 American Arsabletlon at Insurance Services, Inc., used with ihelrpennleclcn i