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HomeMy WebLinkAboutInsurance Certificate: Portland Engineering a~ ° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 0612712017 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 Tina Costa NAME: Ward Insurance Agency PHONE (541)687-1117 FAx (541)342-8280 A1C No Ezt : AIC No PO Box 10167 q~oRESS: tina@wardinsurance.net INSURER(S) AFFORDING COVERAGE NAIC # Eugene OR 97440 INSURERA; Cincinnati Specialty Underwriters Ins. Co. 13037 INSURED INSURER B : Cincinnati Insurance Company 10677 Portland Engineering Inc INSURER c : Commerce & Industry Ins Co 7675 High Banks Rd Ste 1 INSURER D : Continental Casualty Company INSURER E Central Point OR 97502 INSURER F COVERAGES CERTIFICATE NUMBER: 17118 GLIALIUMB/ProflPoll 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 CONTRACTOR 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR AMA RENTED 100,000 PREMISES Ea occurrence $ MED EXP (Any ane person) $ Excluded A Y Y CS00039055 07101/2017 07/0112018 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY ®PRO- ❑ JECT LOC PRODUCTS - COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED ENPlEBA0148589 07101/2017 07/0112018 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Nonowned & HiredAuto $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE EBU014127591 0710112017 07/0112018 AGGREGATE $ 5,000,000 DED RETENTION $ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNERJEXECUTIVE ❑ N!A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under i DESCRiP c i0N OF OPERA-fI0(VS ueiow E.L. DISEASE -POLICY LIMI~f $ Limit : $3,000,000 Ded: $5,000 Pollution Liability D Professional Liability MCH288379629 07101/2017 07/01/2018 Limit : $3,000,000 Ded : $5,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (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 ABOUE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St AUTHORIZED REPRESENTATIVE Ashland OR 97520 ,,r/~ ©1988-2015 ACORD CORPORATION. All rights reserved. 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