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Home My WebLink AboutInsurance Certificate: LTM IncorporatedA ^i `�® CERTIFICATE OF LIABILITY INSURANCE rCERTIFICATE DATE IYYYY) 12/2o/2019l2ots THIS 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 Marsh USA Inc. 333 South 7th Street, Suite 1400 CONTACT NAME_ (A/C.PHONo. t q/c No): _ — E-MAIL ADDRESs: Minneapolis, MN 55402-2400 Attn: MDU.CertRequest@marsh.com; Fax: (212) 948-5382 INSURER AFFORDING COVERAGE _ NAIC # INSURER A: Liberty Mutual Fire Ins Co 23035 CN102299309-LTM%GAWX-20-21 2010 2037 LTMME At Y INSURED LTM, Incorporated dba Knife River Materials INSURER B : Associated Electric & Gas Ins Services Ltd 3190004 -- - INSURER C : Liberty Insurance Corporation 42404 INSURER D : PO Box 1145 Medford, OR 97501 — - — INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-007946941-26 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TB2-641-005097-040 01/01/2020 01/01/2021 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMAGE TO TED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEMLAGGREGATE LIMIT APPLIES PER: AGGREGATE $ 4,000,000 _GENERAL PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY PECOT- LOC $ OTHER A AUTOMOBILE LIABILITY Al2-641-005097-050 01/01/2020 01/01/2021 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 _ BODILY INJURY (Per person; $ IX ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED r NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DNXAMAGE Per a ccident $ UMBRELLALIAB OCCUR XL5063409P 01/0112020 01101/2021 EACH OCCURRENCE �:.- $ 5,000,000 X HCLAIMS-MADE AGGREGATE $ 5,000,000 EXCESS LIAB _ DED I I RETENTION$ $ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIE70R/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A WA7-64D-005097-020(Regulated) WA7-64D-005097-010 (ADS) "Includes"Stop-Gap 01/01/2020 01/01/2021 01/01/2021 X STATUTE EORH - E.L EACH ACCIDENT $ 1,000,000 _ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT _ _ _ $ 1.000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations City of Ashland is/are included as additional insured per the attached CG 2010 and CG 2037 endorsements and does not include professional liability coverage. Blanket Additional Insured for Automobile Liability is included per attached designated Insured Endorsement CA 20 48. Excess liability applies to general liability, products and completed operations, automobile liability, and employers liability. SFr z , . �1, ,y✓ t ij i.� ia,. � l Cel City of Ashland Attn: Kan Olsen 90 N. Mountain Ashland, OR 97520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee W-VL A1aow 11A.,. Ae-.+.,LJ-CA- U 19BB-ZU15 AGUKU GUKI-UKA I IUIV. All rlgnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:AI2-641-005097-050 COMMERCIAL AUTO CA 20 48 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organizations): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy. This policy will be primary and non-contributory to any like insurance available to the person or organization noted above. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 (D Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: AIZ-641-005097-050 Issued By: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Other Person(s)1 Organization(s): Email Address or mailing address: Number Days Notice: Per schedule of Certificate holders on file with the Company Per schedule of certificate holders on file with the Company 9fi A. if we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 0105 11 cD 2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. POLICY NUMBER: TB2-641-005097-040 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • i ! ` i , •' This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by. 1. Your acts or omissions-, or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law: and 2. If coverage provided to the additional insured 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. B. With respect to the insurance afforded to these additional insureds. the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: 1. All work. including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed,- or 2. That portion of "your, wc*" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principa as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement. the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations-, SCHEDULE whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 2010 0413 1c) Insurance Services Office. Inc., 2012 Page 1 of 2 SCHEDULE (continued) Name Of Additional Insured Person(s) Or Organization(s): Any person or organization with whom you have agreed in writing in a contract or agreement, prior to an "occurrence" or "offense", that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in item (1) above. Location(s) Of Covered Operations All locations as required by a written contract or agreement entered into prior to an 'occurrence` or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 2010 0413 (c) Insurance Services Office, Inc., 2012 Page 2 of 2 POLICY NUMBER. TB2-641-005097-040 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ►rr s • on • - • - 9 s. i This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury' or "property damage" caused, in whole or in part. by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law: and 2. If coverage provided to the additional insured 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. Name Of Additional Insured Person(s) Or Organization(s): B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: SCHEDULE Any person or organization for whom you have agreed in writing in a contract or agreement, prior to an "occurrence" or "offense", that such person or organization be added as an additional insured on your policy,, and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in item (1) above. If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required bythe contract or agreement: or 2. Available under the applicable Limits of Insurance shown in the Declarations: whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Location And Description Of Completed Operations All locations as required by a written contract or agreement entered into prior to an "occurrence" or offense. Information required to complete this Schedule, if not shown above. will be shown in the Declarations. CG 2037 0413 ,c, Insurance Services Office. Inc., 2012 Page 1 of 1 Policy Number TB2-641-0415097-040 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY- UMBRELLA COVERAGE FORM Schedule Name of Other Person(s) / Email Address or mailing address: Number Days Notice: ar ianizatio - - — --a t--------------- I Per Schedule of certificate -- - 90 ! holders on file Aith the Com I - ---- I � A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 05 11 (D 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. A. It we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or niailing address listed below at least 10 day%, or the number of days listed below, it any, before cancellation becomes effective. in no event does the notice to the third party exceed [lie notice to the first narned insured. I B. This advance notification of a pending cancellation of coveraga is intended as a courtesy only. Otir falkire to provide such advanoe notificadon will not oxtend the policy cancellation date nor negate cancellation of the policy. RMITYMM Name of Other Person(s) I Email Address or mailing address: Number Days Notice: Organization(a): Schedule on file with the Schedule on file with the 90 Mirripairly wirnparly All other terms and conditions of this Policy remain U"Cjjajr)god. Issued by Liberty ln%irance Gorpora(ion 2`1814 For attachment to Policy No - INA7-64D-005097-01 0 Effective Date Premium $ Issued to Centennial Energy Holdings, Inc. WC 99 20 75 Q 2016 Liberty Mutual Insurance Page I of I Ed, 1210112016 A. It we cancel this policy for any reason other than nonpayment of premium, we will notify the persons of organizations shown in the Sch Mule below, We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below. it any, before cancellation becomes effective. In no event does the notice to the third patty exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtasy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s) I Email Address or mailing address: Organization(s): Schedule on file with the Schedule on file with the company company �.Il other terms and conditions of this policy remain unchanged. Issued by Liberty trisurance Corporation 211i14 For attachment to Policy No. VVA7-64D-005097-020 Effective Date Issued to MDU Resources Group, Inc. Number Days Notice: 90 Premium $ WC 99 20 75 th 2D16 Llbwy Mutual Insurance Page I of 1 Ed. 12101l2016