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HomeMy WebLinkAboutInsurance Certificate: ProTurf International ATE (MM/DD/Y`.., ACC CERTIFICATE OF LIABILITY INSURANCE P07/28/2016 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). PRODUCER CONTACT Hart Insurance Agency NAME: Julie A Maphet PO Box 1240 aC No Ext: (541) 479-5521 a No: E-MAIL Grants Pass OR 97528 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURERA:American Hallmark Insurance Co 43494 INSURED (541) 690-6446 INSURERB:Insco Insurance Service Inc ProTurf International, LLC INSURER C : 2305-C Ashland St. #178 INSURER D: Ashland OR 97520 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: Cert ID 424 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 POLICY NUMBER MM/DD/YYYY MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 -7 DAMAGE TO RENTED CLAIMS-MADE X OCCUR 44CL434145 09/01/2016 09/01/2017 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 X Voluntary PD PERSONAL &ADV INJURY $ 11000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS - COMP/OP AGG $ INCLUDED JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 A ANY AUTO 44CL434145 09/01/2016 09/01/2017 BODILY INJURY (Per person) $ OWNED X SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED 1 RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER AN YP R OPR I E TO R/PA RTN ER/EXE C UT I V E OFFICER/MEMBEREXCLUDED? ❑ N / A E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Bond 251166C 03/17/2016 03/17/2017RSC Bond $ 15,000 i $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Blanket additional insured status with waiver of subrogation on a primary/non-contributory basis for General Liability as required by written contract per MP9767 10/10.Project Name: Omar's Median- Water Conservation Artificial Turf Pilot Project. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 2