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HomeMy WebLinkAboutInsurance Certificate: Pro Turf International Al DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE o7/o1/2D19 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: Julie A Maphet Hart Insurance Agency PHONE FAX PO Box 1240 (A/C.No.ExtI: (541) 479-5521 (A/C,No):(541) 474-1890 E-MAIL ADDRESS: j ma p hetihartinaurance.corn li Grants Pass OR 97528 INSURER(S)AFFORDING COVERAGE NAIC 8 INSURER A:American Hallmark Insurance Co 43494 INSURED (541) 890-6446 INSURER B:Developers Surety and Indemnit 12718 Pro Turf International, --- INSURER C: 2305-C Ashland St. #178 INSURERD: Ashland OR 97520 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 12723 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 W LIMITS LTR INSD VD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) A Y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 AMAGE TO CLAIMS-MADE X OCCUR Y Y 44CL434145 09/01/2019 09/01/2020 pREMSES(EaEoccurrence) $ 100,000 MEDEXP(Anyoneperson) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENII AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 _ POLICY X PRO- POLICY LOC PRODUCTS-COMP/OPAGG $ INCLUDED OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A ANY AUTO 44CL434145 09/01/2019 09/01/2020 BODILY INJURY(Perperson) $ OWNED , BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS -_ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNERIEXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ Eyes,describe under DESCRIPTION OF OPERATIONS below ,E.L.DISEASE-POLICY LIMIT $ B Contractors Bond 251166C 03/17/2019 03/17/2021RSC Bond $ 15,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Blanket additional insured status with waiver of subrogation on a primary/non-contributory basis for General Liability as required by written contract per MP9767 10/10. Project Name: Omar's Median- Water Conservation Artificial Turf Pilot 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. 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1