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HomeMy WebLinkAboutInsurance Certificate: Pressure Point Roofing Inc. (3) R ® CERTIFICATE OF LIABILITY INSURANCE GATE(MM OD YYYY) A0 04/01/2019 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 NAME: Hart Insurance Agency - Medford PHONE Tom Ralduneki FAX PO Box 1240 (A/C.No.Ert): (541) 779-4232 (AIC,No): . E-MAIL Grants Pass OR 97528 ADDRESS: kdolmageBhartineurance-corn INSURER(S)AFFORDING COVERAGE NAICD INSURERA:Mutual of Enumclaw Insurance C 14761 INSURED (541) 772-1945 INSURER B:Cincinnati Specialty Underwrit 13037 Pressure Point Roofing Inc INSURER C: 5235 Rainbow Drive INSURERD: Central Point OR 97502 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 11777 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 SUER POLICY EFF POLICY EXP LIMITS INSD WVD POLICY NUMBER IMMIDDIYYYY) fMID MDIYYYY) B X COMMERCIAL GENERALuABILITY EACH OCCURRENCE $ 1,000,000 DAIIM1GE ID RENTED CLAIMS-MADE X OCCUR Y Y CSU0068454 03/29/2019 03/29/2020 PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY R JEa LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 A X ANY AUTO Y CPP0002914 12/06/201812/06/2019 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS _ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident/ B X UMBRELLA LIAB X OCCUR CSU0068455 03/29/2019 03/29/2020 EACHOCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN PER 0TH' STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE NIA EL EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ $ I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate holder is additional insured per forms CG2503 05/09 Per Project Aggregate, CSGA437 12/13 Additional Insured, and CSGA4087 12/12 Waiver attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street AUTHORIZEDREPRESENTATIVE /Cain Ashland OR 97520 Cl ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1 COMMERCIAL GENERAL LIABILITY CSGA 4087 12 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - PER CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8.Transfer of Rights of Recovery Against Others to Us of SECTION IV-CONDITIONS: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. • • Includes copyrighted material of Insurance CSGA 4087 1212 • Services Office, Inc.,with its permission. Page 1 of 1 COMMERCIAL GENERAL LIABILITY • CSGA 437 12 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - OPERATIONS AND COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured 2. If coverage provided to the additional in- any person or organization when you and such sured is required by a contract or agree- person or organization have agreed in writing ment, the insurance afforded to such ad- in a contract or agreement that such person or ditional insured will not be broader than organization be added as an additional insured that which you are required by the con- on your policy, but only with respect to "bodily tract or agreement to provide for such ad- injury", "property damage" or "personal and ditional !insured. advertising injury"caused, in whole or in part, B. With respect to the insurance afforded to by: these additional insureds, the following addi- 1. Your ads or omissions in the perform- tional exclusions apply: ance of your ongoing operations for the This insurance does not apply to: additional insured; 2. The acts or omissions of those acting on 1. 'Bodily injury","property damage"or"per- ur behalf in the omissions of those of your sonal and advertising injury' arising out of • your p the rendering of, or the failure to render, ongoing operations for the additional in- any professional architectural, engineer- sured; or ing or surveying services, including: 3. "Your work" performed for the additional a. The preparing,approving, or failing to insured and included in the "products- prepare or approve, maps, shop completed operations hazard". drawings, opinions, reports, surveys, If not specified otherwise in the written con- field orders, change orders or draw- tract or agreement, a person's or organiza- ings and specifications; or tion's status as an additional insured under this b. Supervisory, inspection, architectural endorsement ends one year after your opera- or engineering activities. tions for that additional insured are completed. The written contract or agreement must be 2. "Bodily injury" or "property damage" aris- currently in effect or become effective during ing out of"your work" for which a consoli- the term of this Coverage Part.The contract or dated (wrap-up) insurance program has agreement must be executed prior to the"bod- been provided by the prime contrac- ily injury", "property damage" or "personal and tor/project manager or owner of the con- advertising injury' to which this endorsement struction project in which you are involved. pertains. 3. 'Bodily injury","property damage"or"per- However: sonal and advertising injury' to any em- 1. The insurance afforded to such additional ployee of you or to any obligation of the additional insured to indemnity another such only applies to the extent permit- on because of damages arising out of such ted by law; and injury. • Includes copyrighted material of ISO CSGA 437 12 13 Properties, Inc., with its permission. Page 1 of 2 4. 'Bodily injury","property damage"or"per- D. With respect to the insurance afforded to sonal and advertising injury'for which the these additional insureds, SECTION IV - Named Insured is afforded no coverage COMMERCIAL GENERAL LIABILITY CON- under this policy of insurance. DITIONS, 4. Other Insurance is amended to C. With respect to the insurance afforded to include: these additional insureds, SECTION III -LIM- Any coverage provided herein will be excess ITS OF INSURANCE is amended to include: over any other valid and collectible insurance available to the additional insured whether The limits applicable to the additional insured primary, excess, contingent or on any other are those specified in the written contract or basis unless you have agreed in a written con- agreement or in the Declarations of this Coy- tract or written agreement executed prior to erage Part, whichever is less. If no limits are any loss that this insurance will be primary. specified in the written contract or agreement, This insurance will be noncontributory only if the limits applicable to the additional insured you have so agreed in a written contract or are those specified in the Declarations of this written agreement executed prior to any loss Coverage Part. The limits of insurance are in- and this coverage is determined to be primary. clusive of and not in addition to the limits of in- surance shown in the Declarations. Includes copyrighted material of ISO CSGA437 1213 Properties, Inc.,with its permission. Page 2 of 2 POLICY NUMBER:CSU0068454 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): As Required by a Written Contract Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. For all sums which the insured becomes le- shown in the Declarations nor shall they gaily obligated to pay as damages caused by reduce any other Designated Construc- "occurrences" under Section I - Coverage A, Lion Project General Aggregate Limit for and for all medical expenses caused by acci- any other designated construction project dents under Section I - Coverage C, which shown in the Schedule above. can be attributed only to ongoing operations at a single designated construction project 4. The limits shown in the Declarations for shown in the Schedule above: Each Occurrence, Damage To Premises Rented To You and Medical Expense 1. A separate Designated Construction continue to apply. However, instead of Project General Aggregate Limit applies being subject to the General Aggregate to each designated construction project, Limit shown in the Declarations, such lim- and that limit is equal to the amount of the its will be subject to the applicable Desig- General Aggregate Limit shown in the nated Construction Project General Ag- Declarations. gregate Limit. 2. The Designated Construction Project B. For all sums which the insured becomes le- General Aggregate Limit is the most we gaily obligated to pay as damages caused by will pay for the sum of all damages under "occurrences" under Section I - Coverage A, Coverage A,except damages because of and for all medical expenses caused by acci- "bodily injury" or "property damage" in- dents under Section I - Coverage C, which eluded in the "products-completed opera- cannot be attributed only to ongoing opera- tions hazard", and for medical expenses tions at a single designated construction pro} under Coverage C regardless of the ect shown in the Schedule above: number of: 1. Any payments made under Coverage A a. Insureds; for damages or under Coverage C for medical expenses shall reduce the b. Claims made or"suits"brought; or amount available under the General Ag- c. Persons or organizations making gregate Limit or the Products-completed claims or bringing"suits". Operations Aggregate Limit, whichever is applicable;and 3. Any payments made under Coverage A for damages or under Coverage C for 2. Such payments shall not reduce any medical expenses shall reduce the Des- Designated Construction Project General ignated Construction Project General Ag- Aggregate Limit. gregate Limit for that designated con- C. When coverage for liability arising out of the struction project.Such payments shall not "products-completed operations hazard" is reduce the General Aggregate Limit provided, any payments for damages be- CG 25 03 05 09 © Insurance Services Office, Inc.,2008 Page 1 of 2 ❑