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HomeMy WebLinkAboutInsurance Certificate-Day Management Corporation ~r ED, DATE (MM/DDNYYY) A CERTIFICATE OF LIABILITY INSURANCE 3/29/2018 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 Robyn Greene NAME: The Leavitt Group of Boise, Inc. PHONE (208) 672-6160 A No; (666)429-3119 6220 N. Discovery Way, Ste 100 ADDRESS:robyn-MAIL INSURERS AFFORDING COVERAGE NAIC # Boise ID 83713 INSURERA:National Union Fire Insurance 019445 INSURED INSURER B:Navl ators Specialty Insurance 36056 Day Management Corporation INSURERC:New Hampshire Insurance Cc 23841 dba Day Wireless Systems INSURERD: 4700 SE International Way INSURER E: Milwaukie OR 97222 INSURER F COVERAGES CERTIFICATE NUMBER:18/19 Master 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. POLIC POLICY EXP rA TYPE OF INSURANCE ADDL SUWVD BR POLICY NUMBER MMIDDYIYYYY MMIDD/YYYY LIMITS (I I1 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE CLAIMS-MADE ❑ OCCUR PREMSES~aoccu ence $ 500,000 GL 5342023 4/1/2018 4/1/2019 MED EXP (Any one person) $ 25,000 PERSONAL & ADV INJURY $ 1, 000, 000 GENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a JPERO LOC PRODUCTS - COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED CA 3786644 4/1/2018 4/1/2019 BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10, 000, 000 DED X RETENTION$ PTIBEXC885592IV 4/1/2018 4/1/2019 $ WORKERS COMPENSATION WA Stop Gap X S PER - TATUTE EERH AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN NIA E.L. EACH ACCIDENT $ 1,000,000 C (Mandatory in NH) EXCLUDED? WC 025893651 (AOS) 4/1/2018 4/1/2019 ( ry E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DES WC 025893652 (CA) 4/1/2018 4/1/2019 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, Oregon, and its elected officials, officers and employees are included as additional insured in regards to General Liability and Auto Liability where required by written contract. General Liability and Auto Liability are primary & non-contributory where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Ted Rice/ROGREE 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) POLICY NUMBER: GL 534-20-23 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance policy provided that: Condition and supersedes any provision to the (1) The additional insured is a Named Insured contrary: under such other insurance; and Primary And Noncontributory Insurance (2) You have agreed in writing in a contract This insurance is primary to and will not or agreement that this insurance would seek contribution from any other insurance be primary and would not seek contribu- available to an additional insured under your tion from any other insurance available to the additional insured. CG 20 01 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2018 forms a part of policy No. CA 378-66-44 issued to Day Ivianagemeni Corporation by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. 1 Authorized Representative or Countersignature (in States Where Applicable) 74445 (10/99) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY GL 534-20-23 CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Location(s) Of Covered Operations Any person or organization whom you become Per the contract or agreement. obligated to include as an additional insured as a result of any contract or agreement you have entered into. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to or "property damage" occurring after: include as an additional insured the person(s) or 1. All work, including materials, parts or organization(s) shown in the Schedule, but only equipment furnished in connection with such with respect to liability for "bodily injury", work, on the project (other than service, "property damage" or "personal and advertising maintenance or repairs) to be performed by injury" caused, in whole or in part, by: or on behalf of the additional insured(s) at 1. Your acts or omissions; or the location of the covered operations has 2. The acts or omissions of those acting on been completed; or your behalf; 2. That portion of "your work" out of which in the the injury or damage arises has been put to performance of your ongoing operations its intended use by any person or for the additional insured(s) at the location(s) organization other than another contractor or designated above. subcontractor engaged in performing However: operations for a principal as a part of the 1. The insurance afforded to such additional same project. insured only applies to the extent permitted C. With respect to the insurance afforded to these by law; and additional insureds, the following is added to 2. If coverage provided to the additional Section III - Limits Of Insurance: insured is required by a contract or If coverage provided to the additional insured is agreement, the insurance afforded to such required by a contract or agreement, the most additional insured will not be broader than we will pay on behalf of the additional insured that which you are required by the contract is the amount of insurance: or agreement to provide for such additional 1. Required by the contract or agreement; or insured. 2. Available under the applicable Limits of B. With respect to the insurance afforded to these Insurance shown in the Declarations; additional insureds, the following additional whichever is less. exclusions apply: This insurance does not apply to "bodily injury" This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ❑ CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2018 forms a part of Policy No. CA 378-66-44 issued to DAY MANAGEMENT CORPORATION by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: Any person or organization for whom you are contractually bound to provide Additional Insured status but only to the extent of such person's or organization's liability arising out of the use of a covered "auto". 1. SECTION II - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. AUTHORIZED REPRESENTATIVE 87950 (9/14) Includes copyrighted information of Insurance Services Office, Inc., Page 1 Of 1 with its permission.