Loading...
HomeMy WebLinkAboutInsurance Certificate : LTM, Inc ACORO® DATE(MMIDD/YYYY) `�. CERTIFICATE OF LIABILITY INSURANCE 06/02/2023 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 / ' CONTCONTACT Marsh,IU.S.Operations MARSH USA LLC. • P333 South 7th Street,Suite 1400 (A/C. o.Ext): 866-966-4664 FAX No): 212-948-5382 Minneapolis,MN 55402-2400 E-MAIL Minnea olis.CertRe uest marsh.com ADDRESS: p q • INSURER(S)AFFORDING COVERAGE NAIC# CN103060364-LTMM-GAWX-23-24 LTMME INSURER A:Liberty Mutual Fire Ins Co 23035 INSURED INSURER B:N/A N/A LTM,Incorporated dba Knife River Materials _INSURER C: ' PO Box 1145 INSURER D Medford,OR 97501 ' INSURER E: INSURER F: COVERAGES. CERTIFICATE NUMBER: CHI-010373300-09 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 SUER POLICY EFF POLICY EXP LIMITS LTR INSD YWVD POLICY NUMBER • (MM/DD/YYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY TB2-641-445905-323 01/01/2023 01/01/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PRPREMISES((S RENTEDEa occurrence) $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC ; PRODUCTS PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY AS2641446115033 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) X 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 AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WA264D446115013 06/01/2023 05/01/2024 X PER EOTH- R AND EMPLOYERS'LIABILITY STATUTE ER Y/N • 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N N/A 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A General Uab.Excess Buffer TL2641446115043 06/01/2023 05/01/2024 Each Occ/Pers.&Adv.Injury 4,000,000 GL Agg./Prod.-Comp Ops Agg 4,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Asphalt Delivered. The City of Ashland and its officers,employees,and agents while acting within the scope of their duties as such is/dre included as additional insured under general liability where required by written contract and does not include professional liability coverage. Blanket Additional Insured for Automobile Liability is included where required by written contract. Primary and Non-Contributory applies for General Liability where required by written contract. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 90 N.Mountain Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. . AUTHORIZED REPRESENTATIVE ' ©1988-2016 ACORD CORPORATION. All rights reserved. . ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • • Marsh USA LLC 11001 Lakeline Blvd., Bldg. 1, SO Harsh ure200 Austin;TX 78717 Minneapolls.CertRequest©m arsh.com June.2-,-2023 To Whom It:May`Concern: The attached.'certificate of Insurance replaces any previously is sued:certificates you received for the.Named Insured. The actual,policies are in`the process of being issuedrso endorsements cannotbe provided at this:time: For additional assistance, contact your local Knife River representative. Regards, ' U.S. Operations &Technology I Marsh.USA LLC • Kariann Olson From: Thomas McBartlett III Sent: Friday,June 02,2023 12:16 PM To: Kariann Olson Subject: FW:Knife River Corporation Renewal Certificate Attachments: .cert_CHI_City of Ashland_10373300 9.pdf Hi Kari Here is an updated insurance cert from Knife River. • Regards, Tom McBartlett, Director of Electric City of Ashland • Email: mcbartlettt@ashland.or.us Phone:541.552.2314 This email transmission is official business of the City of Ashland,and it is subject to Oregon Public Records Law for disclosure and retention; If you have received this message in error, please contact me at(541)552-2314.Thank you. From: NoReply.Certs@marsh.com<NoReply.Certs@marsh.com> Sent: Friday,June 2,2023 11:49 AM To:Thomas McBartlett III<thomas.mcbartlett@ashland.or.us> 0 Subject: Knife River Corporation Renewal Certificate [EXTERNAL SENDER] Reply To : Minneapolis.CertRequest@Marsh.com • PLEASE DO NOT REPLY TO THIS EMAIL. USE THE REPLY-TO EMAIL ADDRESS INSTEAD. THIS IS A POST-ONLY MAILING. MAIL SENT TO THIS ADDRESS CANNOT BE ANSWERED. . If you no longer need this COI or the contact email for this Certificate needs to be updated please respond to USOperations.email@marsh.com with the attached Certificate confirming no longer needed status or the new email address and we will update the Certificate of Insurance record in our system accordingly. 0 •