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HomeMy WebLinkAboutInsurance Certificate: Wendtco Web Printing ACC) DATE DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE x6/13/2019 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 POUCIES 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: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX HOME OFFICE: P.O. BOX 328 (A/C,No,Ext):888-333-4949 (A/C,No):507-446-4664 OWATONNA, MN 55060 ADDRESS:CLIENTCONTACTCENTERa.FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 344-174-8 INSURER B: WENDTCO WEB PRINTING INCORPORATED,VALLEY WEB PRINTING INSURER C: 1299 STOWE AVE MEDFORD,OR 97501-6612 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:7 REVISION NUMBER:0 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 INSR WVD (MM/DDIYYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 5100,000 PREMISES(Ea occurrence) MED EXP(My one person) EXCLUDED A Y Y 9820268 07/31/2019 07/31/2020 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 RO- POLICY JECT LOC PRODUCTS-COMP/OP AGO $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 51,000,000 (Ea accident X ANY AUTO BODILY INJURY(Per person) SCHEDULED A OWNED AUTOS ONLY AUTOS N N 9820268 07/31/2019 07/31/2020 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000 A EXCESS LIAB CLAIMS-MADE N N 9820269 07/31/2019 07/31/2020 AGGREGATE $2,000,000 DED RETENTION WORKERS COMPENSATION OTH- PER STATUTE AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF ASHLAND, ITS OFFICERS AND EMPLOYEES ARE NAMED ADDITIONAL INSURED AS PER WRITTEN CONTRACT. WAIVER OF SUBROGATION IS PROVIDED IN FAVOR OF THE CERTIFICATE HOLDER. THE GENERAL LIABILITY COVERAGE CONTAINS A WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATEHOLDER SUBJECT TO THE CONDITIONS OF THE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US ENDORSEMENT. CERTIFICATE HOLDER CANCELLATION 344-174-8 7 0 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE 20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE '/` VtA, 104.01,1,6-1 O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 9820268 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations: Location(s) Of Covered Operations CITY OF ASHLAND See IL-F-40-0001 20 E MAIN ST ASHLAND OR 97520 ,nformation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising P P Y damage"ert dams e" occurrin 9 after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its insured only applies to the extent permitted by intended use by any person or organization law; and other than another contractor or subcontractor engaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. WENDTCO WEB PRINTING INCORPORATED 1299 STOWE AVE MEDFORD OR 97501 © Insurance Services Office, Inc., 2012 Page 1 of 2 CG 20 10 04 13 Policy Number: 9820268 Transaction Effective Date: 07-31-2019 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III - Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 Policy Number 9820268 Transaction Effective Date: 07-31-2019 EXTENSION ENDORSEMENT Extension - CG 20 10- CITY OF ASHLAND ANY COVERAGE PROVIDED BY THIS ENDORSEMENT APPLIES ONLY WHILE THE WORK DONE FOR THE ADDITIONAL INSURED BY WENDTCO WEB PRINTING INCORPORATED IS IN WENDTCO'S OWN CARE, CUSTODY, AND CONTROL. ANI: VALLEY WEB PRINTING. ADDITIONAL INSUREDS ALSO INCLUDE: CITY OF ASHLAND, ITS OFFICERS AND EMPLOYEES IL-F-40-0001 (05-10) Policy Number: 9820268 Transaction Effective Date: 07-31-2019 POLICY NUMBER: 9820268 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above 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 the person or organization shown in the Schedule above. DESCRIPTION OF INTEREST IF APPLICABLE: ANY COVERAGE PROVIDED BY THIS ENDORSEMENT APPLIES ONLY WHILE THE WORK DONE FOR THE ADDITIONAL INSURED BY WENDTCO WEB PRINTING INCORPORATED IS IN WENDTCO'S OWN CARE, CUSTODY, AND CONTROL. ANI: VALLEY WEB PRINTING © Insurance Services Office, Inc., 2008 Page 1 of 1 CG 24 04 05 09 Policy Number: 9820268 Transaction Effective Date: 07-31-2019 gBWNDHBS 344-174-87 XWXW0021XXXXXXX5# BE002.01-0059 ITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1814