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HomeMy WebLinkAboutInsurance Certificate: OBEC Consulting Engineers, Incr CERTIFICATE OF LIABILITY INSURANCE DATEt2 /ODl1'YYY) AC�O 03/25 V/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 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: Parker,Smith&Feek,Inc. PHONE 42$-709-3600 FAX 425-709-7460 2233 112th Avenue NE -J-M E-MAIL'No Eatl: INC,No): Bellevue,WA 98004 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC d INSURER A: Continental Casualty Company INSURED INSURER B: Sentinel Insurance Company OBEC Consulting Engineers,Inc. 920 Country Club Road,Suite 1008 INSURER c: Hartford Ins.Co.of the Midwest Eugene,OR 97401 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 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 OF AODCl UBRI POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) A GENERAL LIABILITY 6024757366 03/20/2019 03/20/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MEDEXP(Any one person) $ 10.000 PERSONAL BADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 7 POLICY A JFCT a IE LOC S B AUTOMOBILE LIABILITY 52UECPT7B13 03/20/2018 06/01/2019 (EeaBCeeDt51NGLE LIMIT $ 2,000,000 K ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS POPEEnDAMAGE X HIRED AUTOS NON-OWNED (erRet) A UMBRELLA LIAB X OCCUR 6024757383 03/20/2019 03/20/2020 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED X RETENTIONS 10,000 $ WORKERS COMPENSATION 52WBCRT5496 X WCSTATU- OTH- C AND EMPLOYERS'LIABILITY YIN 03/20/2019 03/20/2020 TORY LIMITS FR ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (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 S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD tot,Additional Remarks Schedule,if more space is required) Project No.05-15-Railroad Crossing Improvement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Dept 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland,OR 97520 5114y_ . ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 3 of 4 (CCSOO) 1 DATE(MM/DD/YYYY) A�° CERTIFICATE OF LIABILITY INSURANCE 03/25/2019 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 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: - Parker,Smith 8 Feek,Inc. PHONE 425-709-3600 FAX 425-709-7460 2233 112th Avenue NE (A/C.No,B.p:._.._. (Arc.No): E-MAIL • Bellevue,WA 98004 ADDRESS: • INSURER(S)AFFORDING COVERAGE NAIC INSURER A: Continental Casualty Company INSURED INSURERS: Sentinel Insurance Company OBEC Consulting Engineers, Inc. 920 Country Club Road,Suite 100B INSURER c: Hartford Ins.Co.of the Midwest Eugene,OR 97401 INSURER D: 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR VWD POLICY NUMBER IMMIDD/YYYY) (MM/DD/YYW) LIMITS A GENERAL LIABILITY 6024757366 03/20/2019 03/20/2020 EACH OCCURRENCE $ 2,000,000 • X COMMERCIAL GENERAL LIABILITY PRI ET R N E TO( a occ Tu rr ence) $ DAEMA 300,000 G CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10.000 PERSONAL B ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4.000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 POLICY X TEC X LOC $ B AUTOMOBILE LIABILITY 52UECPT7813 03/20/2018 06/01/2019 I ee ceeDISINGLE LIMIT $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS NON-OWNED PROPERTY acciden DAMAGE $ $ A UMBRELLA LIMB X OCCUR 6024757383 03/20/2019 03/20/2020 EACH OCCURRENCE $ 1,000,000 K EXCESSLIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMP,ENSATIDN 52WBCRT5496 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N 03/20/2019 03/20/2020 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT 5 1,000.000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes.describe under 1000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD let,Additional Remarks Schedule,If more space Is required) Project-Calle Guanajuato Waterline Design. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Karl Johnson,E.I.T.Associate Engineer 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland,OR 97520 /u/ - C.({ - _ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 3 of 4 (CCS00) City of Ashland Attn: Karl Johnson, E.I.T.Associate Engineer 20 East Main Street Ashland, OR 97520 1 of 4 (CCS00) A ® CERTIFICATE OF LIABILITY INSURANCE DA03/25/20 9(MMIDDIYYYY) 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 NAME: Parker,Smith&Feek,Inc. PHONE 425-709-3600 FAX 42$-709-7460 E-M 2233 112th Avenue NE No.Extl: INC,N01. E-MAIL Bellevue,WA 98004 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Continental Casualty Company INSURED INSURER B: Sentinel Insurance Company OBEC Consulting Engineers,Inc. 920 Country Club Road,Suite 100B INSURER C: Hartford Ins.Co.of the Midwest Eugene,OR 97401 INSURER 0: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMIDDIYYYYI,(MMIDDNYYY) ' LIMITS A GENERAL LIABILITY 6024757366 03/20/2019 03/20/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 300,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 7 POLICY X JFf° X LOC $ B AUTOMOBILE LIABILITY 52UECPT7813 03/20/2018 06/01/2019 1 aealptleD?INGLE LIMIT $ 2,000,000 X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S NON-OWNED PROPERTY DAMAGE HIRED AUTOS g AUTOS (Per accident) s A UMBRELLA LIAB X OCCUR 6024757383 03/20/2019 03/20/2020 EACH OCCURRENCE $ 1,000,000 — K EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ 1'000'000 DED K RETENTIONS 10,000 $ C WORKERS COMPENSATION 52WBCRT5496 K WCS ATU - OTH- AND EMPLOYERS'LIABILITY YIN 03/20/2019 03/20/2020 TORY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 5 1,000,000 If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) Contract for Personal Services-Project Management,Utility Coordination,and Project Engineering Work for the Oak Street Railroad Crossing Project. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Karl Johnson,E.I.T.Associate Engineer 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland,OR 97520 �/ - C•(/, r I �iN—' �dl// ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 3 of 4 (CCSOO) City of Ashland Attn: Morgan Wayman 20 East Main Street Ashland, OR 97520 1 of 4 (CCSO01 A`OR D 03/25/22019 019 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ ) 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 NAME: Parker,Smith 8 Feek,Inc. PHONE 425-709-3600 FAX 425-709-7460 2233 112th Avenue NE JAIL,No-Ext1: INC,No): E-MAIL Bellevue,WA 98004 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC ft INSURER A: Continental Casualty Company INSURED INSURER B: Sentinel Insurance Company OBEC Consulting Engineers,Inc. 920 Country Club Road,Suite 1008 INSURER c: Hartford Ins.Co.of the Midwest Eugene,OR 97401 INSURER D: 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 TYPE OF INSURANCE ADOL SUER POUCY EFF POLICY EXP LIMITS LTR INSR WAD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYYI A GENERAL LIABILITY 6024757366 03/20/2019 03/20/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED K COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 300.000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 li GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 4,000,000 7 POLICY X l EOT F LOC $ B AUTOMOBILE LIABILITY 52UECPT7813 03/20/2018 06/01/2019 (Ee accitleD BwGLE LIMIT $ 2,0OQ000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per acddenn $ A UMBRELLA LIAB K OCCUR 6024757383 03/20/2019 03/20/2020 EACH OCCURRENCE $ 1,000,000 K EXCESS LIAB CLAIMS-MADE AGGREGATE S 1,000,000 DED X RETENTIONS 10,000 $ C WORKERS COMPENSATION 52WBCRT5496 WC STATU- 0T AND EMPLOYERS'LIABILITY YIN 03/20/2019 03/20/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ' E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 10 , 00000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Design of a New 15-Inch Sanitary Sewer along A Street from 1st St.to 7th St.(PWE:Project No.2013-17). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Morgan Wayman 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland,OR 97520 �I C;'//, - 7Y7Nd"/'V ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 3 of 4 (CCS00) City of Ashland Engineering Dept 20 East Main Street Ashland, OR 97520 1 of 4 (CCS00)