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HomeMy WebLinkAboutInsurance Certificate: Metals Treatment Technologies Client#:33569 METTREPC ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/VYYY) 9/26/2017 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 N2MEAOT Nick Brown Holmes Murphy-Colorado {A/D,PHONE Na,Ext):720-622-9110 FAX (A/C,No): 544-248-0468 7600 East Orchard Road,Suite 330 South ADDRESS: nbrown @holmesmurphy.com Greenwood Village,CO 80111 INSURER(S) NAIC# INSURER A:Starr Indemnity&Liability Com 38318 INSURED INSURERS:AGCS Marine Insurance Company 22837 Metals Treatment Technologies,LLC dba MT2,LLC INSURER C: 14045 West 66th Avenue NSURER D: Arvada,CO 80004 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 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 ADDLSUBR POLICYEFF POLICYEXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER LIMITS (MM/DDIYVVV) (MMIDD/WYY) A X COMMERCIAL GENERAL LIABILITY X 1000065167171 10/01/2017 10/01/2018 E $1 EACH 1000,000 D CLAIMS-MADE X OCCUR PREMISES(ESEao u ante) $100,000 X BI/PD Ded:$2,500 MEDEXP(Anyoneperson) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _$2,000,000 PRO- POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY SISIPCA08275017 10/01/2017 10/01/2018 (EO aei deDtsINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) A UMBRELLALIAB X OCCUR 1000336207171 10/01/2017 10/01/201$EACH OCCURRENCE $8,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $8,000,000 DED X RETENTION$0 $ A WORKERS COMPENSATION 100000148903 10/01/2017 10/01/2018 X STATUTE ETH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE V/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? Y N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Leased/Rented Eq. SML93024512 10/01/2017 10/01/2018 $1,000,000;$1,000 Ded B Installation Flt. SML93024512 10/01/2017 10/01/2018 $1,000,000;$1,000 Ded A Pollution/Prof. 1000065167171 10/01/2017 10/01/2018 $1Mii Occ/$2Mil Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:Ashland Gun Club Trap/Skeet Range As required by written contract or written agreement,the City of Ashland,Oregon,and its elected officials,officers and employees are included as Additional Insured under General Liability and Automobile Liability on a primary and non-contributory basis with respect to the above referenced. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y o s THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E.Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE 6444:r ©1988.2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #5308096/M307952 MANVi • COMMERCIAL GENERAL LIABILITY • CG 20 10 0413 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 Organization(s): Location(s)Of Covered Operations • Where Required By Written Contract Where Required By Written Contract 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 1. All work, including materials, parts or include as an additional insured the person(s) or equipment furnished in connection with such organization(s) shown in the Schedule, but only work, on the project (other than service, with respect to liability for "bodily injury", "property maintenance or repairs) to be performed by or damage" or "personal and advertising injury" on behalf of the additional insured(s) at the caused, in whole or in part, by: location of the covered operations has been 1. Your acts or omissions; or completed; or 2. The acts or omissions of those acting on your 2• That portion of "your work" out of which the ( behalf; injury or damage arises has been put to its in the performance of your. ongoing operations for intended use by any person or organization in the additional or performance insured(s)f r. at the location(s)r other than another contractor or subcontractor engaged in performing operations for a designated above. principal as a part of the same project. However: • 1. The insurance afforded to such additional C. With respect to the insurance afforded to these insured only applies to the extent permitted by additional insureds, the following is added to law; and Section III—Limits Of Insurance: 2. If coverage provided to the additional insured is If coverage provided to the additional insured is required by a contract or agreement, the required by a contract or agreement, the most we insurance afforded to such additional insured will pay on behalf of the additional insured is the will not be broader than that which you are amount of insurance: required by the contract or agreement to 1. Required by the'contract or agreement; or provide for such additional 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 endorsement shall not increase the This insurance does not apply to "bodily injury" or applicable Limits of Insurance shown in the "property damage"occurring after: Declarations. • t CG 20 10 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 330413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or 1. "Bodily injury", "personal that such person or organization be Y 1 ry", "Property damage" or personal added as an additional insured on your policy, and advertising injury" arising out of the Such person or organization is an additional rendering of, or the failure to render, any insured only with respect to liability for "bodily professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury"caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions; or prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, behalf, in the performance of your ongoing change orders or drawings and operations for the additional insured, specifications; or However, the insurance afforded to such additional b. Supervisory, inspection, architectural or engineering activities. insured: 1. Only applies to the extent permitted by law; and This exclusion applies even if the claims against any insured allege negligence or other wrongdoing 2. Will not be broader than that which you are in the supervision, hiring, employment, training or required by the contract or agreement to monitoring of others by that insured, if the provide for such additional insured. "occurrence" which caused the "bodily injury" or A person's or organization's status as an additional "property damage", or the offense which caused insured under this endorsement ends when your the "personal and advertising injury", involved the - - - ---operations for that additional insured are rendering of or the failure to render any completed. professional architectural, engineering or surveying services. CG 20 33 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 2. "Bodily injury" or "property damage" occurring same project. after: C. With respect to the insurance afforded to these a. All work, including materials, parts or additional insureds, the following is added to equipment furnished in connection with Section III -Limits Of Insurance: such work, on the project (other than The most we will pay on behalf of the additional service, maintenance or repairs) to be insured is the amount of insurance: performed by or on behalf of the additional 1. Required by the contract or agreement you insured(s) at the location of the covered have entered into with the additional insured;or operations has been completed; or 2. Available under the applicable Limits of b. That portion of"your work" out of which the P Y Insurance shown in the Declarations; injury or damage arises has been put to its intended use by any person or organization whichever is less. This endorsement shall not increase the applicable than another contractor or PP licable subcontractor engaged in performing Limits of Insurance shown in the Declarations. operations for a principal as a part of the Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 33 0413