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HomeMy WebLinkAboutInsurance Certificate: Fregonese & Associates a DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/24/2017 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: Ronni Phillips Elliott Powell Baden and Baker Inc. PHONE (503) 227-1771 FAX (503)274-7644 AIC No Ext : A/C No): 1521 S.W. Salmon Street ADDRILSS:rphillips@epbb.com INSURERS AFFORDING COVERAGE NAIC # Portland OR 97205-1783 INSURER A: Sentinel Insurance Co, LTD 11000 INSURED INSURER B :SAIF Corporation 52412 Fregonese & Associates, Inc INSURER C:Westchester Fire Insurance 1525 SW Park Ai*e. INSURER D : INSURER E : Portland OR 97201 INSURER F: COVERAGES CERTIFICATE NUMBER:17 -18 GL AU WC & E&O 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 EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A CLAIMS-MADE Fx_1 OCCUR DAMAGE TO RENTED 11000,000 PREMISES Ea occurrence $ X 52SBAPW4493 3/1/2017 3/1/2018 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F PRO- JECT [7] LOC PRODUCTS - COMP/OP AGG $ 2,000,000 X OTHER: Employment Practices Liability $ 10 , 0 0 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 000 Ea accident $ 11000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS 5256APW4493 3/1/2017 3/1/2018 BODILY INJURY (Per accident) $ X X NON-OWNED PeOaPERT DAMAGE $ HIRED AUTOS AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 11000,000 DED X RETENTION$ 10,000 52SBAPW4493 3/1/2017 3/1/2018 $ PER WORKERS COMPENSATION X S TATUTE ORH _ AND EMPLOYERS'' IABILiTY _ ANY PROPRIETOR/PARTNER/EXECUTIVE Y E.L. EACH ACCIDENT $ 11000,000 OFFICER/MEMBER EXCLUDED? NIA 900667 3/1/2017 3/1/2018 B (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional Liability 627571256 3/27/2017 3/27/2018 2,000,000 $5000 SIR DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is included as an additional insured as respects the operation of the named insured per attached SS0008 04/05. CERTIFICATE HOLDER CANCELLATION april.lucas@ashland.or.us SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 51 Winburn Way ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Ronni Phillips/CB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The:ACORD name and logo are registered marks of ACORD INS025 (201401) COMMENTS/REMARKS City of Ashland, Oregon, and its elected officials, officers and employees are named as additional insureds. OFREMARK COPYRIGHT 2000, AMS SERVICES INC.