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HomeMy WebLinkAboutInsurance Certificate: Alpine Enviromental Consultants r----''~"`' ALPI N-5 O P I D: S H CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYY) 0510512017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS C~R71FiCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BE~.OW. 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). 503-397-0714 coNTACT Joe Schultz :PRODUCER NAME: NFP Property & Casualty Svcs PHONE 503-397-0714 Fax 503-397-0674 61 Plaza Square (AIC, No, Ext): (A1C, No): St. Helens, OR 97051 E-MAIL ADDRESS: Joe Schultz INSURERS AFFORDING COVERAGE NAIC # INSURER a :Homeland Insurance Co of NY i INSURED Alpine Environmental INSURER B Consultants, LLC INSURER C 12208 Antioch Road Whlte Clty, OR 97503 INSURER D INSURER E 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 ABO`JE 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 IN D WVD POLICY NUMBER MMlDD1YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE ❑X OCCUR X 793-00-21-64-0003 05/0712017 0510712018 DAMAGE TO RENTED 50000 PREMI E Ea occurrence $ NonOwned Auto MED EXP An one erson $ 5,000 Hired Auto PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ~ X POLICY ❑ PRO- ❑ LOC PRODUCTS - COMPIOP AGG $ 2,000,000 i JECT OTHER: $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ _ ANY AUTO BODILY INJURY Per erson $ OWNED 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 RETENTION $ $ PER OTH- WORKERS COMPENSATION TAT TE ER AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ~ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under ' DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ I~~ q Pollution Liab 793-00-21-64-0003 05107/2017 0510712018 Limit 2,000,000 I, A Professional Liab 793-00-21-64-0003 0510712017 05107/2018 Limit 2,000,000 Il ~er a~tac~ied en~osementsTB~l~l~~31~1; R~1Q~~~itjp~l~gr~arkasn cJ~g~~~q~~y,b~i~a~l~e~l if more space is required) I I CERTIFICATE HOLDER CANCELLATION !i CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, OR, ItS ACCORDANCE WITH THE POLICY PROVISIONS. ~I elected officials, officers and employees AUTHORIZED REPRESENTATIVE 20 East Main Street ~ Ashland, OR 97520 ~'f-~ ACORD 25 (2016103} ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number; 793-00-21-64-0003 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-OUVNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION -FORM I This endorsement only modifies coverage provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the=; Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II -WHO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed far that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added; 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after; (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds) at the site of the covered operations has been completed; or (b) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain the same. OBENV GE 301 (0211) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E-INSURED THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NaN-C®NTRIDUTORY END®RSEMENT This endorsement modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SECTION IU -CONDITIONS, 8.Other Insurance, is amended by adding the following paragraph: This insurance will be considered primary to, and non-contributory with any other insurance issued directly to a person or organization added as an additional insured under this policy, only if you specifically agree, in a written contract or agreement, that this insurance must be primary to, and non-contributory with, such other insurance. All other terms and conditions remain the same. OBENV GE 319 (0211) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011, OneBeacon Insurance Group LLC E-INSURED a~~nsNr~ pal dnoap aaueansu! uoooa8aup ' ~ 60Z ~y6!a~dop ~ p ~ ~ou! 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