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HomeMy WebLinkAboutInsurance Certificate: Vitus Construction Inc ` ® ADATE(MMlDD/YYYY)v CERTIFICATE'OF 'LIABILITY INSURANCE . . 6/16/2022 THIS CERTIFICATE IS ISSUED.AS A'MATTER OF INFORMATION ONLY ANDCONFERS 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,certainpolicies may require an endorsement.. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s): PRODUCER • CONTACTNAME: Charris Sonne-Phinney. Anchor Insurance and Surety; Inc PHONE FAX PO Box 2808 • (A/C.No.Ext): 503-224-2500 (NC,No):503-224-9830 Portland OR 97208-2808 ADDRESS: certificates@anchorias.com INSURER(S)AFFORDING COVERAGE NAIC# , INSURER A:Union Insurance Company- 25844 INSURED ' ' VITUCON-01 INSURER B:SAIF Corporation 36196 . Vitus Construction Inc. PO Box 1097 INSURER C:Indian Harbor Insurance Co. ' . ' 36940 Gold HiII OR 97525 INSURER D INSURER E: COVERAGES CERTIFICATE NUMBER 678697199 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 W ' ' POLICY EFF POLICY EXP .- LIMBS LTR INSD VD POLICY NUMBER (MM/DDIYYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY. Y• CPA 6040088 6/18/2022 . .6/18/2023 EACH OCCURRENCE' $1,000,000 DAMAGE TO RETED CLAIMS-MADE X. OCCUR PREMISES ES(Ea occurrence) $300,000 MED EXP(Any one person) . $10,000' PERSONAL&ADV INJURY $1,000,000 GEN L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE .. .$2;000,.000 '.. . X: PRO- POLICY JECT : LOC PRODUCTS-COMP/OP AGG $2,000,000' $ OTHER: A AUTOMOBILE LIABILITY Y CPA 6040088 6/18/2022 6/18/2023 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) :$ OWNED SCHEDULED BODILY INJURY.(Per accident) $ AUTOS ONLY AUTOS HIRNON-OWNED PROPERTY DAMAGE X AUTEDOS ONLY X AUTOS ONLY. (Per accident) • $ A X UMBRELLA LIAB X OCCUR ' Y CPA 6040088 6/18/2022 6/18/2023 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE • - AGGREGATE $10;000,000 DED RETENTION$ $. . g WORKERS COMPENSATION: 811648 10/1/2021 10/1/2022 X STATUTE ERH OR AND EMPLOYERS'LIABILITY . Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE . N/A E.L.EACH ACCIDENT $1,000,000. OFFICERIMEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE.$1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below. E.L.DISEASE-POLICY LIMIT :$1,000,000 C. Profession&Pollution Liability PEC005004805 6/18/2022 6/18/2023 Occur 1,000,000!Agg 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate holder and all other entitiesare additional insureds when specified by written contract.Coverage is primary&non-contributory and includes waiver of subrogation when required by written contract.All subject to the terms,conditions and exclusions of the policies.Endorsements attached:CLCG0529 10/18; CLCG2071 09/16;CLCG0492 10/18;CLCA01.49 07/21;WC000313: Goods and Services Agreement 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. 20 East MainStreet Ashland OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CARRIER: Union Insurance Company POLICY NUMBER: cPA604008e COMMERCIAL GENERAL LIABILITY INSURED: Vitus Construction Inc. CL CG.04 92 10 18 THIS ENDORSEMENT CHANGES.THE POLICY.. PLEASE READ IT CAREFULLY. GENERAL LIABILITY .ULTRA PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SUMMARY OF COVERAGE EXTENSIONS Provision Name Of Coverage Extension Included or Limit of Insurance A. Miscellaneous Additional Insureds Included B: Expected Or Intended InjuryOr Damage Included C. Knowledge Of Occurrence. Included . . . D. Legal Liability-Damage To Premises Rented To You (Fire, Lightning, $300,000 ' Explosion,Smoke,'Or Leakage From Automatic Fire Protective Systems). E. Medical Payments. See Declarations F. Mobile Equipment Redefined Included G. Newly Formed Or Acquired Organization, Partnership Or Limited Liability . Included Company And Extended.Period Of Coverage . H. Who Is An Insured—Amendment Included I. Non-Owned Watercraft(Increased to maximum length of less than 51 . ' Included feet) J. Supplementary Payments=Increased Limits 1. Bail Bonds $3;000 2.: Loss Of Earnings $ 1,000 K. Unintentional Omission Or Unintentional Error In Disclosure Included. L. Waiver Of Transfer Of Rights Of Recovery Against Others Included M. Liberalization Clause Included N. Incidental Medical Malpractice. Included The above is a summary only.Pleaseconsult the:specific provisions that follow for complete information on the extensions provided. The.provisions of the Commercial' General Liability in writing in.a contract or agreement that such. Coverage Part apply except as otherwise provided in person or organization be added as additional insured on your policy, provided this endorsement.. This'.endorsement applies only,if, that such Coverage.Part is included in this policy: • A. MISCELLANEOUS ADDITIONAL INSUREDS a, The written contract or written agreement is: 1. Section II—.Who Is An Insured is amended to include as an' insured any person or g (1) Currently in effect or becomin effective during thetermof this policy; organization (referred to as an additional ' ' and ' insured below) described in Paragraphs A.1.c.(1).through A.1.c.(9) below when you. ' . . (2) Fully.. executed: by 'you and. the' and such personor organization have agreed. • ' . additional insured prior to the "bodily CL CG 04 9210.18 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 8 - with its permission injury", "property damage" or (1.1) The preparing, approving, "personal and advertising'injury".. or failing to prepare or b. The insurance afforded by this provision - approve, maps, shop drawings, opinions, reports, does not . apply to any person or . surveys, field orders, organization included as an .additional insured by a separate endorsement change orders or drawings issued by us and made a part of this policy and specifications; or or covera a part:: . 9 - - �" � � (1.2). Supervisory, inspection, c. Only the following persons or architectural or engineering organizations are additional insureds activities: under this provision, with 'coverage for This exclusion "applies even if the such additional insureds limited as claims against any insured allege provided herein: negligence or other wrongdoing in the (1) Persons or .Organizations For supervision, hiring, employment, Whom Operations Are Performed training or monitoring of others by that insured," if the "occurrence" which (a) Any person or organization for caused the"bodily injury"or"property whomou are y performing. . damage", .or the offense which operations when you and such caused the "personal and advertising person .or . organization . have injury",.involved the rendering of, or agreed in writing in a contract or the failure to render, any professional agreement that such person or architectural, engineering or organization be added as an surveying services. ' additional insured to your policy; " " " and. (II) Bod ily injuryor prop erty damage"occurring after: , Anyother.person or organization (b) • 1) Allwork, including you are required to.add as an . . � additional insured under the materials, parts or contract or agreement described equipment furnished in connection with such in paragraph(a)above. work; on the project (c) Such person(s)or organization(s) ' ' (other than service, is an additional insured only with maintenance orrepairs) respect. to liability for "bodily to be performed by or on injury"; "property damage" or behalf of the additional "personal.and advertising injury" ' _ insured(s) at the location caused, in whole or in part,by: of the covered operations (I) Your acts or omissions; or has.been completed; or (1.2) That portion of "your (II) The acts or.'omissions of: work" out of which the. those acting onyour behalf; . . injury or.damage arises in the performance of your ongoing has been. put to its " " operations for the additional insured. " . ' ' intended: use . by any (d) With respect to the insurance person or organization other than another afforded to these additional contractor or insureds, the following additional subcontractor engaged in exclusions apply:: performing operations for This insurancedoes not apply to: a principal as a part of the (I) . "Bodily injury.",. ."property same project. damage Or "personal and (2) Managers Or,Lessors Of Premises advertising injury" arising out A manager or lessor of premises but of the rendering of, or the only with respect.to liability arising out failure to , render, any , - of the ownership, maintenance or use professional architectural, of that part of the premises leased to engineering or , surveying services, including:" CL CG 04 8210.18 Includes copyrighted material of Insurance Services Office,Inc., .Page 2 of 8 with its permission you and subject. to the following contract or written agreementwith additional exclusions: you for such leased equipment ends. This insurance does not apply to: This insurance does not apply to any (a) Any "occurrence" which takes "occurrence" which takes place after place after you cease to be a the equipment lease expires. tenant in that premises. (6) State,.Municipality, Governmental (b) Structural alterations, new . Agency Or Subdivision Or Other construction ' or demolition Political Subdivision.-Permits-Or operations performed by or on . Premises nations Relating To behalf of such additional insured. Premises (3)Mortgagee,Assignee Or Receiver Any state, municipality, governmental agency or subdivision or other A mortgagee,'assignee, or receiver political subdivision subject to the but only with respect to their liability ' following additional provisions: as mortgagee, assignee, or receiver and arising out of the ownership,: (a) This insurance applies only with maintenance,, or use of a covered respect to: premises by you. (I) The following' hazards for This insurance does not apply to which the state, municipality, structural alterations, new governmental agency or construction or demolition operations subdivision or other political subdivision. has issued a performed by,or on behalf of such. permit or authorization in additional insured. connection with premises you (4) Owners Or.Other Interests From own, rent or control and .to Whom Land Has Been Leased which this insurance'applies: An owner or other interest from whom (1.1) The ' . existence, land has been leased to you but only maintenance, repair, With respect"to liability arising out'of construction, erection the.ownership, maintenance or use of or removal of that part of the land leased to you and ' advertising signs, subject to the following additional awnings, canopies, exclusions: I cellar entrances; coal holes, driveways, This insurance does not apply to: manholes, marquees, (a) Any "occurrence" which takes hoist away openings, place after you cease to lease sidewalk vaults, street that land. banners or decorations and similar exposures; (b) Structural alterations,. new or construction. or ' demolition operations performed by or on (1.2) Theconstruction, behalf of such additional insured: erection or removal of (5) Lessor'Of Leased'Equipment ors; or . .. elevators; Any person(s)or organization(s)from_ (1.3) The ownership maintenance you lease equipment but only maintenance or use of with respect to liability for "bodily any elevators covered injury", " r erty damage" or by this insurance: R oR Y 9 "personal. 'and advertising injury" ' (II) Operations performed by you Caused, in whole or in part, by your or on your behalffor which maintenance, operation or use of the state, municipality, equipment leased to you by such governmental . agency or person(s)or organization(s). subdivision or other.political A person's or organization's status as subdivision has issued a permit or authorization. an additional insured under this endorsement ends when their written CL CG 04 821018 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 8 with its permission (b) This insurance does not apply to (III)Any physical or chemical "bodily injury", "property.damage change in the product made or "personal and advertising intentionally _ by the injury" arising out of operations . . . vendor; performed for . the state, municipality, governmental (iv) Repackaging,. except when agency or subdivision or other unpacked solely for thepurpose of inspection, political subdivision.. demonstration,testing, or the (7) Controlling Interest substitution of parts under Any person(s) or organization(s) with instructions from the a controlling. interest in the Named manufacturer; and then repackaged in the original Insured but only with respect to their . liability arising out of: container; (a)Their financial control of you;or (v) Any failure. to make such inspections, adjustments, (b) Premises theyown, maintain or tests or servicing as the control while you lease or occupy vendor has agreed to make these premises. or normally undertakes to make in-the usual course of This insurance does not apply to business,'in connection with structural alterations, new t sale distribution or sa a of the construction or demolition operations products; performed by or for such person(s)or organization(s). (vi) Demonstration, installation, (8) Co-Owner Of Insured Premises servicing or repair . operations, except such A co-owner of a premises co-owned operations performed at the by. .you and covered _ under . this_ vendor's. . . premises in insurance but only with respect to the connection with .the sale of co-owner's liabilityas co-owner .of the product; such premises. (v11); Products which, after (9) Vendors distribution or sale by you, have been labeled. or (a) Any person(s) or organization(s) relabeled or used as a (referred to, as vendor), but only container, part or ingredient with respect to "bodily injury" or of any other thing or "property damage" arising out of substance by or for the "your products" which are distributed.or sold in the regularvendor; or course of the vendor's business. (v111)"Bodily injury" or "property The insurance' .afforded the damage" arising out of the sing. sole negligence of the vendor vendor does not apply to: for its own acts or omissions (I) "Bodily injury" or "property or thoseof itsemployees or damage" for which : the anyone else acting on its vendor is, obligated .to pay behalf. However, • this damages by reason of the exclusion does not apply to:. assumption ofliability in a (1.1). The exceptions written contract .or written contained in Sub- agreement. This . exclusion p a paragraphs does not apply to liability for (vl);or it or damages that the vendor . . would have in the absence.of (1.2) Such . inspections, the written contract or written adjustments, tests or agreement; servicing as the vendor has agreed to (II) Any express warranty . make or normally unauthorized by you; undertakes to make. CL CO.04 9210.18 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 8 with its permission in the usual course of B. 'EXPECTED OR INTENDED INJURY OR business, • in DAMAGE connection with the Exclusion 2.a• Expected.Or Intended injury of : distribution or sale of: . the products. Section I Coverage A. BodilyInjury And Property Damage :Liability is. eleted and (b) This insurance does not replaced by the following: apply toany insured person • a. Expected Or.Intended Injury Or Damage_ =- or organization; from whom: you have acquired products; "Bodily injury"or"property damage"expected or any ingredient, part or or intended from the standpoint of the insured. container, entering :into, This exclusiondoes not apply to"bodily injury" . . . accompanying or containing or"property damage"resulting from the use of such products. reasonable forceto protect . persons or 2.. With .respect to coverage provided by this. property. Provision A: Miscellaneous Additional : C._ KNOWLEDGE OF OCCURRENCE insureds, the following additional provisions Paragraph_ 2.a. Duties in The Event Of apply' Occurrence, Offense, Claim Or Suit of Section a. Any insurance provided to an additional IV— Commercial General Liability Conditions insured designated under Paragraphsis deleted and replaced by the following: A.1.c.(1) through `A.4.c.(8)• above does not.apply: notified a. You must see to it that weare as soon as practicable of. an "occurrence" or. an (1) To : "bodily injury" or "property offense which may result in a claim only when damage" included within the the"occurrence"or offense is known to: • "products-completed operations hazard"; or (1) You, if you are an individual; (2) To."bodil in u "property dama e" (2) A partner;if you are.a partnership; . . Y i j ry', lie" or personal and. advertising .injury". •(3) A manager, if you are a limited liability arising out of the sole negligence.:ofcompany; or such.additional insured. An "executive 'or t "employee (4) cutive officer theploye b. The insurance afforded to such additional designated by you to give such notice, if insured only applies to . the extent you are an organization other than a permitted by law.: partnership or a limited liability company. c. The insurance afforded to such additional To the extent possible; notice should include: insured will not be broader than that which , How,when and where the"occurrence"or. you are required to provide by the written- (1) ff contractor written agreement.. offtook place; 3. With respect to the.insurance afforded to.the (11)- The. names and addresses of any injured persons additional, insureds within this.Provision- A- a witnesses;and wit sses; and Miscellaneous Additional insureds, the (Ili)The nature and location of any injury or following is added to Section ill-"Limits Ofdamage arising out of the"occurrence"or Insurance:. offense: The most we will pay on behalfof the D. LEGAL LIABILITY -DAMAGE TO PREMISES additional insured is the amount of insurance: RENTED TO YOU (Fire, Lightning, Explosion, S a. Required by the written,contract or.written: ok Or Leakage From Automatic. Fire m agreement or Prot a Systems) . . L Available under theapplicableLimits Of• . If damage to premises rented. to you is not. Insurance shown in the Declarations; otherwise excluded from this policy_ or coverage • part,then the following provisions apply: whichever.is less. 1. Under Section I- - Coverage A -.Bodily This endorsement shall not increase the Injury:And Property"Damage Liability, the applicable Limits Of Insurance shown in the last paragraph(after the exclusions)is deleted Declarations. and replaced by the following: CL CG 04 821018 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 8 with its permission