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HomeMy WebLinkAboutInsurance Certificate: Electrical Consultants, Inc. ELECCON-05 MTOS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/06/2018 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 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 NAM : Billings Office Payynewest Insurance, Inc. (A/C, No, Ext): (406) 238-1900 (n/c, No :(406) 245-9887 P.O. Box 30638 ADD IL Billings, MT 59107-0638 INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Fire Insurance Company of Hartford 20478 INSURED INSURER B : The Continental Insurance Company 35289 Electrical Consultants, Inc. INSURER C : Continental Casual Company 20443 3521 Gabel Road INSURER D: Zurich American Insurance Company 16535 Billings, MT 59102-7307 INSURER E : Montana State Fund 15819 INSURER F, I 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS IN WVD IMM/DDfYYYYI / D/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS-MADE X OCCUR 6015980113 11/01/2017 11/01/2018 DAMAGES(RENTED 300,000 Ea or X PR MI urrence $ MED EXP An one person) $ 15'000 PERSONAL & ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000'000 POLICY JECT FX LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: Employee Benefi $ 1,000,000 B COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY a a cid n $ X ANY AUTO 6014516577 11/01/2017 11/01/2018 BODILY INJURY Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15'000'000 EXCESS LIAB CLAIMS-MADE 6015980127 11/0112017 11/01/2018 AGGREGATE $ 15,000,000 DED X RETENTION $ 10,000 $ D WORKERS COMPENSATION X PTR T OTH- E AND EMPLOYERS' LIABILITY Y/N WC959744507 01/01/2018 01/01/2019 1,000,000 E.L. EACH ACCIDENT W ANY FROPRIETORIPARTNERIEXECUTIVL OFFICER/MEMBER EXCLUDED? Y I N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C Professional/Poll Lit AEH114043145 09/10/2018 09/10/2019 Per Claim 10,000,000 E Montana Work Comp 032578445 01101/2018 01/01/2019 1,000,000 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,, CNA75079XX, CA0444 and SCA23500D. 30 Day Notice of Cancellation Clause applies perform CNA74658xx. Umbrella is follow form. Blanket Additional Insured applies to Umbrella. Worker's Compensation Waiver of Subrogation applies per written contract per form W0000313. . SEE ATTACHED ACORD 101 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 ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE %9~ n TO ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ELECCON-05 MTOS LOC 1 A ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Cons Roadtants, Inc. Billings Office 3521tGabel 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/Locations/Vehicles: "*Workers Comp Information for Policy WC959744507 Coverage A States: AZ, CA, CO, FL, MN, MO, NJ, OK, TN, TX, UT, WI, HI, NV, OR Coverage A Statutory Employers Liability Limits for Policy WC959744507: Each Accident: $1,000,000/Disease - Each Employee: $1,000,000./Disease -Part 3 Other States Included - All except monopolistic and MT Professional and Pollution Coverage information: Claims-made Coverage. Deductible Endorsement Ded per claim including claim expenses $350,0000 Retro Active Date: 09/10/98 Policy Number: AEH114043145 All operations performed by the above insured. Named Insured includes: Electrical Consultants, Inc., ECI Engineering Services PC, EPC Services Company: ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD