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HomeMy WebLinkAboutInsurance Certificate: Electrical Consultants, Inc. (2) ______....4„ ELECCON-05 CTHELEN ACORO DATE(MM/DD/YYYY) 4i.......--- CERTIFICATE OF LIABILITY INSURANCE 12/13/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS i 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: Billings Office Paynewest Insurance,Inc. ja"c°°,No,Ext):(406)238-1900 (NC,No):(406)245-9887 P.O.Box 30638 E-MAIL SS: Billings, MT 59107-0638 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:National Fire Ins of Hartford 20478 INSURED INSURER B:Continental Ins Co 35289 Electrical Consultants, Inc. INSURER C:Continental Casualty Company 20443 3521 Gabel Road INSURER D:Zurich American Insurance Company 16535 Billings,MT 59102-7307 INSURER E:Montana State Fund 811212 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI (MM/DD(YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 CLAIMS-MADE X OCCUR X 6015980113 11/01/2017 11/01/2018 Eaoccur nce) $ 300,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECOT- X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Employee Benefi $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) _S X ANY AUTO 6014516577 11/01/2017 11/01/2018 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS WN BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLYY PROPEcidR (Per acent TY DAMAGE $ $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000 EXCESS LIAB CLAIMS-MADE 6015980127 11/01/2017 11/01/2018 AGGREGATE $ 15,000,000 DED X RETENTION$ 1 0,000 $ D WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE ERH WC959744507 01/01/2018 01/01/2019 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? Y 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 and AEH114043145 09/10/2017 09/10/2018 Pollution Each Claim 10,000,000 E Montana Work Comp 032578445 01/01/2018 01/01/2019 1,000,000 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 per form CNA74658xx. Worker's Compensation Waiver of Subrogation applies per written contract per form WC000313..Umbrella is follow form. Blanket Additional Insured applies to Umbrella. 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 Y ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland,OR 97520 AUTHORIZED REPRESENTATIVE// ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ELECCON-05 CTHELEN LOC#: 1 AFRO ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Billings Office 3521 tGabel R adtants,Inc. POLICY NUMBER Billings,MT 59102-7307 SEE PAGE 1 CARRIER NAIC CODE SEE 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/LocationsNehicles: **Workers Comp Information for Policy WC959744504**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- Policy Limit: $1,000,000 Part 3 Other States Included -All except monopolistic and MT Professional Coverage information: Claims-made Coverage. Deductible Endorsement--Ded per claim including claim expenses $350,0000 Named Insured includes: Electrical Consultants, Inc., ECI Engineering Services PC, EPC Services Company: Retro Active Date: 09/10/98 Policy Number: AEH114043145 All operations performed by the above insured. All operations performed by the above insured. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD