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Insurance Certificate: Cornforth Consultants Inc
Client#:320005 . CORNFCON • DATE(MM/DD/YYYY) ACORIA CERTIFICATE OF LIABILITY INSURANCE 11/01/2022' 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 any rights to the certificate holder in lieu of such endorsement(s). ' PRODUCER CONTACT Please See Below. NAME: . USI Insurance Services NW PR PHONE 206 441-6300 FAX 610-362-8530 (A/C,No,Ext): (AIC,No): 601 Union Street,Suite 1000 E-MAIL Seattle.PLCertRe uest usi.com ADDRESS: q Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIC# • INSURER A:Berkley Insurance Company 32603 INSURED INSURER B: Cornforth Consultants ;Inc. INSURER C: 10250 SW Greenburg Rd.,Suite 111 . • Portland,OR 97223-5460 INSUR • ER INSURER E INSURER F: COVERAGES . CERTIFICATE NUMBER: • 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 LTRINSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ • CLAIMS-MADE OCCUR DAMAGE REM SES.(Ea occurrence) $. . MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ • PRO-POLICY • JECT LOC PRODUCTS-COMP/OP AGG $ i OTHER: $ . • AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) • ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED • 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 . . r AGGREGATE • $ DED RETENTION$ - $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ' • OFFIBPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT $ • (Mandatory 1n NH) . E.L.DISEASE-EA EMPLOYEE $ . If yes,describe under' • DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional X AEC906007407 11/01/2022 11/01/2023•$2,000,000 per claim Liability $4,000,000 annl aggr. Incl.Pollution DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional.Remarks Schedule,may be attached if more space Is required) RE: CCI Job#2700,CCI: Hosler Dam Part 12. • • CERTIFICATE HOLDER ' CANCELLATION City of Ashland, Public Works Department • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES.BE CANCELLED BEFORE p THE EXPIRATION DATE THEREOF, NOTICE •WILL BE DELIVERED IN Attn:Tami Campos ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street • Ashland,OR 97520-0000 AUTHORIZED REPRESENTATIVE . • I 9 a 4.�_ . ©1988-2015 ACORD CORPORATION.All.rights reserved. . ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD . #S37942969/M37931506AZLZP pix November 03, 2022 RE: Certificate of Insurance for City of Ashland, Public Works Department To Whom It May Concern, We are pleased to inform you that USI Insurance Services is now utilizing CertVaultbyPatra to deliver and store certificates of insurance for our client,Cornforth Consultants, Inc.. On their behalf,we have uploaded a new certificate(s)in CertVault for you to view and download. To register for certificate access:. 1. Visit https://certvault.orcr and select Sign In. 2. From the sign-in page, select Register. 3. Enter the access code below to verify your account and view your certificate(s). Access Code:tyCupKC7 If you have already registered for a CertVault account,you may merge this request to your existing account by following these steps: 1. Visit https://certvault.orcq and sign into your account. 2. Click your name in the upper right corner. 3. Click the Claim Access Code button. 4. Enter the access code below and select Submit. Access Code: tyCupKC7 Note:For best results, access CertVault using Google Chrome. If you encounter any issues during the registration process,please contact our help desk: Phone: 415-230-0646 (available M-F, 6:00 am-5:00 pm PST) Email: helndesk(@certvault.org(available M-F, 6:00 am-5:00 pm PST) We hope you enjoy the efficiency, security,and convenience that CertVault brings to certificate delivery. Sincerely, USI Insurance Services Cert Vai I`.BYPATRA USI Insurance Services PO BOX 629035 EL DORADO HILLS CA 95762 City of Ashland, Public Works Department 20 E MAIN ST ASHLAND OR 97520-1814 250-Washington-Northwest