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HomeMy WebLinkAboutInsurance Certificate: Electrical Consultants ELECCON-05 CTHELEN CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/20/2016 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: Billings Office PHONE Pa neWest Insurance, Inc. A/c No Ext : (406) 238-1900 A No : (406) 245-9887 E-MAIL P. O. Box 30638 ADDRESS: Billings, MT 59107-0638 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : National Fire Ins of Hartford 20478 INSURED INSURER B : Continental Ins Co 35289 Electrical Consultants, Inc. INSURER c : Continental Casualty Company 20443 3521 Gabel Road INSURER D : Montana State Fund 15819 Billings, MT 59102-7307 INSURER E : Zurich American Insurance Company 16535 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 ADDL SUBR POLICY EFF POLICY EXXF' LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 i AMA I= LNILU CLAIMS-MADE a OCCUR X 6015980113 11101/2016 11/01/2017 PREMISES Ea occurrence) $ 300,000 l MED EXP (Any one person) $ 15,000 1,000,000 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE Ll LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: Employee Benefi $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident B X ANY AUTO 6014516577 11/01/2016 11/01/2017 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON---OWNED PROPERTY DAMAGE $ Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 14,000,000 C EXCESS LIAB CLAIMS-MADE 6015980127 11/01/2016 11/01/2017 AGGREGATE $ 14,000,000 r DED X RETENTION $ 0 $ WORKERS COMPENSATION X PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY D ANY PROPRIETOR/PARTNER/EXECUTIVE Y~ 032578445 01/01/2016 01/01/2017 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS beiow EL DISEASE_POLICY LIMIT S 1,000,000 C Professional Polluti AEH114043145 09/1012016 09/10/2017 Per Claim & Aggregat 10,000,000 E Workers Compensation WC959744505 01/01/2016 01/01/2017 See Below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Blanket Additional Insured per written contract Including Completed Operations. Primary and Non-Contributory Coverage per written contract. Blanket Waiver of Subrogation per written contract. Blanket additional insured and waiver applies on Auto Coverage per written contract Per forms CNA74705XX, CNA74706XX, CNA74736XX, CNA75079XX, CA0444 and SCA23500D. Worker's Compensation Waiver of Subrogation applies per written contract per form W0000313.. Umbrella is follow form. Blanket Waiver of Subrogation applies to Umbrella. "Workers Comp Information for Policy WC959744504Coverage A States: AZ, CA, CO, FL, ID, MN, MO, NJ, OK, TN, TX, UT, WI SEE ATTACHED ACORD 101 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 I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ELECCON-05 CTHELEN LOC 1 "R . `6 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Cons Billings Office 3521tGabel Roadtants, Inc. POLICY NUMBER Billings, MT 59102-7307 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/LocationsNehicles: Coverage A Statutory Employers Liability Limits for Policy WC959744505: Each Accident: $1,000,000/Disease - Each Employee: $1,000,000./Disease - Policy Limit: $1,000,000 Part 3 Other States Included - All except monopolistic and MT Professional Coverage information: Claims-made Coverage. Deductible Endorsement Ded per claim including claim expenses $350,0000 Named Insured includes: Electrical Consultants, Inc., ECI Engineering Services PC, EPC Services Company: Retro Active Date: 09110198 Policy Number: AEH114043145 All operations performed by the above insured. ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD