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HomeMy WebLinkAboutInsurance Certificate: Portland Engineering A CERTIFICATE OF LIABILITY INSURANCE DAT6/26/201s Y) 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 Lynn Wray Ward Insurance Agency Inc. PHONE FAX PO Box 10167 lac.No.Eat): 541-687-1117 (A/C.No):541-342-8280 EMAIL Eugene OR 97440 ADDRESS: Iynn@wardinsurance.net INSURER(S)AFFORDING COVERAGE NAIC 8 INSURER A:Cincinnati Specialty Underwriters Insurance Compan 13037 INSURED PORTENG-01 `INSURER B:Cincinnati Insurance Company 10677 Portland Engineering Inc 7675 High Banks Rd Ste 1 INSURER C:Commerce and Industry Insurance Company 19410 Central Point OR 97502 INSURER D:Continental Casualty 20443 INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER:1623536511 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDYYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY Y Y CSU0039055 7/1/2019 7/1/2020 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000 MED EXP(Any one person) $Excluded PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JECOT- LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y ENP 0148589 7/1/2019 7/1/2020 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ C UMBRELLA LIAB X OCCUR EBU021332420 7/1/2019 7/1/2020 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE n N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCL UDED7 1 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Pollution Liability MCH288379629 7/1/2019 7/1/2020 Limit$3,000,000 Ded:$5,000 Professional Liability Limit$3,000,000 Ded:$5,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder and all entities required by written contract are included as additional insureds with waiver of subrogation as respects to the general liability including completed operations and auto liability as required by written contract per attached endorsements.Subject to policy limits,terms,conditions and exclusions. 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 Attn: David Gies 20 E Main St Ashland OR 97520 BAUT'/HAORIZEDREPRESENTATIVE 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • COMMERCIAL GENERAL LIABILITY available to the additional insured whether This insurance will be noncontributory only if CSGA4031 06 12 primary, excess, contingent or on any other you have so agreed in a written contract or basis unless you have agreed in a written can- written agreement executed prior to any loss THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. tract or written agreement executed prior to and this coverage is determined to be primary. any loss that this insurance vnll be primary. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - OPERATIONS AND COMPLETED OPERATIONS (LIMITED) This endorsement modifies insurance provided under the following' COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II - WHO IS AN INSURED is b. Supervisory,inspection,architectural amended to include as an additional insured or engineering activities any person or organization when you and such person or organization have agreed in writing 2. "Bodily Injury'or"property damage"aris- ing a contract or agreement that such person or out of'your work"for which a oonsoli- organizatlon be added as an additional Insured dated (wrap-up) insurance program has on your policy,but only to the extent that the li- been provided by the prime contractor/ ability is caused by"your work"performed for project manager or owner of the construc- that additional insured and only to the extent tion project in which you are involved. that such liability is caused by your negligence, 3. "Bodily in' "per- acts or omissions or the negligence,acts or y and ad"property damage"any em- omissions of those acting on your behalf. serial and you or to a injury"bli ati ono ehe ployee of you or to any obligation of the If not spedfied otherwise in the written con- additional Insured to Indemnity another tract or agreement, a person's or organiza- because of damages arising out of such tion's status as an additional insured under this injury. endorsement ends one year after your opera- 4. "Bodily Injury', tions for that additional insured are completed. Y "property injury"u y"for which the The written contract or agreement must be sonal and advertising a afforded for which age currently in effect or become effective during Named Insured is nsur nc . coverage me term of[his Coverage Part The contract or under this policy d insurance. agreement must be executed prior to the"bad- C. With respect to the insurance afforded to ily injury',"property damage"or"personal and these additional insureds,SECTION III-LIM- advertising injury"to which this endorsement ITS OF INSURANCE is amended to;include: pertains. The limits applicable to the additional insured B. With respect to the insurance afforded to the- are those spedfied in the written contract or se additional insureds,the following additional agreement or in the Dedarations of this Coy- exclusions apply: erage Part whichever is less.If no limits are spedfied in the written contract or agreement, This insurance does not apply to: the limits applicable to the additional insured 1. 'Bodily Injury','property damage"or"per- am those epoafiod in tho Dodarations of this serial and advertising injury"arising out of Coverage Part.The limits of insurance are in- the rendering of,or the failure to render, elusive of and not in adcktion to the limits of in- any professional architectural, engineer- surance shown in the Dedarations. ing or surveying services,induding: D. With respect to the insurance afforded to the- a. The preparing.approving,or failing to se additional insureds,SECTION IV-COM- prepare or approve, maps, shop MERCIAL GENERAL LIABILITY CONDI- drawings,opinions,reports,surveys TIONS,4.Other Insurance Is amended to In- field orders,change orders or draw- elude: Trigs and specifications;or Any coverage provided herein will be excess over any other valid and collectible Insurance Indudes copyrighted material of Insurance Indudes copyrighted material of Insurance CSGA 4031 OG 12 services Office,Inc,with its permission. Page 1 of 2 CSGA 4031 00 12 services Office,Inc,with its permission. Page 2 of 2 • • • COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CSGA 408712 12 ADDITIONAL INSURED BY CONTRACT THIS ENDORSEMENT CHANCES THE POLICY.PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: AGAINST OTHERS TO US -PER CONTRACT BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indi- This endorsement modifies insurance provided under the following: toted below. Endorsement Effective: Policy Number: COMMERCIAL GENERAL LIABILITY COVERAGE PART 07-01-2019 EBA 014 85 89 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Named Insured: The following is added to Paragraph 8.Transfer of Rights of Recovery Against Others to Us of SECTION PORTLAND ENGINEERING INC IV-CONDITIONS: Countersigned by: If you have agreed,in a written centrad 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 (Authorized Representative) 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". With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless This waiver applies only to that person or organization for which you have agreed to in a written contract to modified by the endorsement. provide said woiver. SECTION II-LIABILITY COVERAGE,A.Cover- age,I.Who is an Insured is amended to include as an insured any person or organization with which you have agreed in a valid written contract to provide insurance as is afforded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been executed prior to the "bodily injury"or"property damage". Includes copyrighted material of Insurance CSGA 4087 12 12 Cervices Office.Inc.,with its permission. Page 1 of 1 AA 4171 11 05 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION -AUTO PRIMARY AND NONCONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO COVERAGE FORM This endorsement changes the policy effective on the inception cafe of the policy unless another date is indi- This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. cated below. Endorsement Effedive. Policy Number: Endorsement Effective: Policy Number: 07-01-2019 ESA 014 85 89 07-01-2019 EBA 014 85 89 Named Insured: Named Insured: PORTLAND ENGINEERING INC PORTLAND ENGINEERING INC Countersigned by Countersigned by: (Authorized Representative) (Authorized Representative) With respell to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. 1. Blanket Waiver of Subrogation payments we make for"bodily injury'or"prop- erty damage"arising out of the operation of a 1. Noncontributory Insurance SECTION IV - BUSINESS AUTO CONDI- covered"auto"when you have assumed habil- TIONS,A. Loss Conditions,5.Transfer of ity for such"bodily injury"or"property damage" SECTION IV - BUSINESS AUTO CONDI- Rights of Recovery Against Others to Us is under an"insured contract",provided the"bod- TIONS,B.General Conditions,5.Other In- amended by the addition of the following: illy injury"or"property damage"occurs subse- quent surance is replaced by the following: We waive any right of recovery we may have to the execution of the 'insured con- c. Regardless of the provisions of Para- against any person or organization because of trod". graph a.above,this:overage Form's Li- ability Coverage is primary and we will not seek contribution from any other in- surance for any liability assumed under an"insured contract"that requires liability to be assumed on a primary noncon- tributory basis. AA 4172 09 09 AA 4174 11 05