Loading...
HomeMy WebLinkAboutInsurance Certificate: Portland Engineering ACfJR'0 ~ CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDOtYYYY) 6x29/2016 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: Tina Costa Ward Insurance Agency PHONE (541) 687-11.17 FAX WC No Ext : A/C. No : (541):342 -~i2Bt; PO Box 10167 E-MAIL DRSS: A ti na@ ward nsurance . net ADDRE INSURER(S) AFFORDING COVERAGE NAIC # Eugene OR 97440 INSURER A :Cincinnati Specialty Underwriters 13037 INSURED INSURER B :Cincinnati Insurance Companies Portland Engineering, Inc. INSURFRC:Comerce & Industry Ins Co 7675 High Banks Road Suite 1 INSURERD:Continental Casualty Company INSURER E Central Point OR 97502 INSURER F COVERAGES CERTIFICATE NUMBER:16/17 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 J"JITH RESPECT TO V'VHICH 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE. OF INSURANCE POLICY NUMBER MM/DDIYYYY MMJDDtYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 'S 1, 000 , 000 A CLAIMS-11ADE ~ OC°CUR PREMISES E TO RENTED ,E 100 , 000 X Y CSU0039055 7/1/2016 7/1/2017 MED EXP to-, Excluded PERSONAL & ADV INJURY' 3 1,000,000 GEN1 AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 2,000,000 POLICY ~ JECT LOC PRODUCTS - COMPiOP AGG = 2,000,000 OTHER :NA Sop Gu Li ei)il ty S 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LI%1 T IEa i~_.er,t B ANY AUTO BOD€CY INJURY (Pe 5-~_~ ALL O) VNED SCHEDULED AUTOS AUTOS ENF 0148589 7/11/2016 7/-1/2017 BC E I L I NJ x.URY i,F X X N 0 N - O'-,`vtJ E D PROPERTY DAF,:I.AGE - HIRED AUTOS AUTOS P= f X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 5,000,000 C EXCESS LIAB CLAIMS-MADE AGGREGATE S 5,000,000 DEE) RETENTIONS ESU023355209 7/1/2016 7/1/2017 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN StATUIE LR <OF F T, RT' F 'L. vE EL EACH ACCIDENT F ; lE Jc N I A (Mandatory in NH) E_L DISEASE EA EMPLOYE If X vs ae ce _*l ~I DESCRIPTION OF OPERATIONS elcw E L DISEASE - POLICY LIMIT D Proffesional Liability & MCJ;288379529 7/1/201-6 7/1/20) 17 Li-it 2,000,000 Pollution Liability De^. $5 ,000 DESCRIPTION OF OPERATIONS I LOCATIONS I V E HICLES (ACORD 101, Additional Remarks Schedule. maybe 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 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and loge are registered marks of ACORD INS025 a;; COMMERCIAL GENERAL LIABILITY available to the additional insured whether This insurance will be noncontributory only if CSGA4031 0612 primary, excess, contingent or on any other you have so agreed in a written contract or basis unless you have agreed in a written con- written agreement executed prior to any loss tract or written agreement executed prior to and this coverage is determined to be primary. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. any loss that this insurance will be primary. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - OPERATIONS AND COMPLETED OPERATIONS (LIMITED) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II - WHO IS AN INSURED is b. Supervisory, inspection, architectural amended to include as an additional insured or engineering activities, any person or organization when you and such person or organization have agreed in writing 2. "Bodily Injury' or "property damage" aris- in a contract or agreement that such person or ing out of "your work" for which a consoli- organization be added as an additional insured dated (wrap-up) insurance program has on your policy, but only to the extent that the li- been provided by the prime contractor / ability is caused by 'your work" performed for project manager or owner of the construc- that additional insured and only to the extent tion project in which you are involved. that such liability is caused by your negligence, 3. "Bodily injury", "property damage" or "per- acts or omissions or the negligence, acts or sonal and advertising injury" to any em- omissions of those acting on your behalf. ployee of you or to any obligation of the if rest specified otherwise in the nrritten cox,.- additional insured to indemnity another tract or agreement, a person's or organiza- because of damages arising out of such tion's status as an additional insured under this injury. endorsement ends one year after your opera- 4. "Bodily injury", "property damage" or "per- tions for that additional insured are completed. sonal and advertising injury" for which the The written contract or agreement must be Named Insured is afforded no coverage currently in effect or become effective during under this policy of insurance. the term of this Coverage Part. The contract or agreement must be executed prior to the 'bod- C. With respect to the insurance afforded to ily injury', "property damage" or "personal and these additional insureds, SECTION III - LIM- advertising injury' to which this endorsement ITS OF INSURANCE is amended to include: pertains. The limits applicable to the additional insured B. With respect to the insurance afforded to the- are those specified in the written contract or se additional insureds, the following additional agreement or in the Declarations of this Cov- exclusions apply: erage Part, whichever is less. If no limits are specified in the written contract or agreement, This insurance does not apply to: the limits applicable to the additional insured 1. "Bodily injury', "property damage" or "per- are those specified in the Declarations of this sonal and advertising injury" arising out of Coverage Part . The limits of insurance are in- the rendering of, or the failure to render, Elusive of and not in addition to the limits of in- any professional architectural, engineer- surance shown in the Dedarations. ing or surveying services, including: D. With respect to the insurance afforded to the- a. The preparing, approving, or failing to se additional insureds, SECTION IV - COM- prepare or approve, maps, shop MERCIAL GENERAL LIABILITY CONDI- drawings, opinions, reports, surveys, TIONS, 4. Other Insurance is amended to in- field orders, change orders or draw- Elude: ings and specifications, or Any coverage provided herein will be excess over any other valid and collectible insurance Includes copyrighted material of Insurance Includes copyrighted material of Insurance CSGA 4031 06 12 services Office, Inc., with its permission. Page 1 of 2 CSGA4031 06 12 services Office, Inc., with its permission. Page 2 of 2 COMMERCIAL GENERAL LIABILITY CSGA 4067 12 12 POLICY NUMBER: CS00039055 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY DESIGNATED CONSTRUCTION PROJECT(S) AGAINST OTHERS TO US - PER CONTRACT GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This endorsement modifies insurance provided under the following: PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION SCHEDULE IV - CONDITIONS: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a [lesignate dConstruction Project(s): person or organization, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or'your work" done When required by written contract. under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. nformation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by "occur- damages or under Coverage C for medical rences" under Section I - Coverage A, and for all expenses shall reduce the Designated Con- medical expenses caused by accidents under struction Project General Aggregate Limit for Section I - Coverage C, which can be attributed that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule gregate Limit shown in the Declarations nor above: shall they reduce any other Designated Con- t. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above. equal to the amount of the General Aggregate 4. The limits shown in the Declarations for Each Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli- "property damage" included in the "products- cable Designated Construction Project Gen- completed operations hazard", and for medi- eral Aggregate Limit. cal expenses under Coverage C regardless of the number of a. Insureds, b. Claims made or "suits" brought: or c. Persons or organizations making claims or bringing "suits". Includes copyrighted material of Insurance CSGA 4087 12 12 Services Office, Inc., with its permission. Page 1 of 1 CG 25 03 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 2 ❑ B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "occur- "products-completed operations hazard" is pro- rences" under Section I - Coverage A, and for all vided, any payments for damages because of medical expenses caused by accidents under "bodily injury" or "property damage" included in Section I - Coverage C, which cannot be attrib- the "products-completed operations hazard" will uted only to ongoing operations at a single des- reduce the Products-completed Operations Ag- ignated construction project shown in the Sched- gregate Limit, and not reduce the General Ag- ule above: gregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned under the General Aggregate Limit or the and then restarted, or if the authorized contract- Products-completed Operations Aggregate ing parties deviate from plans, blueprints, de- Limit, whichever is applicable, and signs, specifications or timetables, the project will 2. Such payments shall not reduce any Desig- still be deemed to be the same construction pro- nated Construction Project General Aggre- ject. gate Limit. E. The provisions of Section III - Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 ❑