HomeMy WebLinkAboutInsurance Certificate : Osmose Utilities Services, Inc �- CERT,
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A -oRn LATE OF.,LIABILITY INSURANCE ` 06/27/2023^
THIS CERTIFICATE IS ISSUED AS A MATTEROF 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 conditionsof the policy,certain policies may require an endorsement A statement on this °f
certificate does not`confer'rights to the certificate holder in lieu of such endorsement(s). c
PRODUCER CONTACy d
NAME:
Aon Risk Services Central,. Inc PHONEFAX
MSC# 17385 (A/C.No.Ext):, C866).283-7122 (A/C-No.):.(800) 363-0105
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Aon ADDRESS:
PO Box'1447- A S: _
Lincolnshire IL 60069 USA '
INSURER(S)AFFORDING COVERAGE NAIL#
INSURED INSURER Ar .-'Old Republic Insurance' Company 24147•
Osmose Utilities Services, ;Inc. - • - ' INSURER B:, ' Starr Indemnity.& Liability Company 38318
635 Highway 74 S
Peachtree City GA 30269 USA. INSURER c;
INSURER D:
INSURER E:.
INSURER
CATE NUMBER:
COVERAGES HIS IS TO CERTIFY THAT THE POLICIES OFl INSURANCE-LISTED 570100290339 REVISION
BELOW HAVE.BEEN ISSUED TO THE.INSUREDAB
MED OR EFOR THE POO L
ICY 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. Limits shown areas requested
INSF1 TYPE OF INSURANCE ADDL SUBR POLICY EFF. POLICY EXP , ..
LTR INSD WVD - POLICY NUMBER MM/DD/YYY MMIDDIVYYY LIMITS "
A , X COMMERCIAL GENERAL LIABILITY MWZY31489423 7/01/102 7/01/102 'EACH OCCURRENCE $2,000,000
CLAIMS-MADE OCCUR
DAMAGE TO RENTED $2,.000,000
PREMISES(Ea occurrence) •
MED EXP(Any one person) $5,000
PERSONAL&`ADV'INJURY $2,000,000 m
GEN LAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE , $4,000,000 ' c
X POLICY ❑PRO-
JECT I I:LOC PRODUCTS-COMP/OP AGG $4,000,000 0
OTHER:
A
' AUTOMOBILE LIABILITY MINTS 315620-23 07/01/2023 07/01/2024 COMBINED SINGLE LIMIT $5,000,000
(Ea accident)
. . _ ...
X-` ANYAUTO, BODILY INJURY(Per person) C
—SCHEDULED .
OWNED.. INJURY(Per accident)
AUTOS.
HIRED AUOTOSY NON-OWNED. . .,.. . OPERTY D t01
' BODILY
PR AMAGE
—ONLY _AUTOS ONLY - (Per accident)
B 1000095518231< 07/01/2023 07/01/2024.EACH OCCURRENCE: $5,000,000
°
UMBRELLALIAB X OCCUR
X EXCESS LIAB CLAIMS-MADE AGGREGATE. $5;000,000
DED RETENTION
A WORKERS COMPENSATION AND - MWC31561923 - ' 07/01/2023 07/01/2024' x PER STATUTE 0TH-
EMPLOYERS'LIABILITY ,' Y/NER:
ANY PROPRIETOR/PARTNER/EXECUTIVE 7 ,• E.L.EACH ACCIDENT $1,000,000 -
OFFICER/MEMBER EXCLUDED?_ N/A
(Mandatory in NH) E,L.DISEASE-EA EMPLOYEE $1,000,000 -
If yes,describe under - '
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000_
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DESCRIPTION OF OPERATIONS/-LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may beattached-it more space Is required)
The City of Ashland, Oregon, and its elected officials,-officers and employeesis included as Additional Insured in accordance
with the policy provisions of the General Liability & Automobile Liability policies ' The General Liability insurance is
primary and'non-contributory over any existing insurance and limited to liabilityarising out-of the operations of the named
insured subject to,policy terms and conditions and whererequired by written contracts A Waiver;of-Subrogationis, granted in
favor of Certificate Holder in accordance with the policy provisions of the General Liability policy.
0.
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 o
POLICY PROVISIONS. o
City of Ashland AUTHORIZED REPRESENTATIVE _ `oo
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�. 20 East Main Street 8
rP - Ashland OR97520USA - o
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@1988-2015 ACORD CORPORATION.All rights'reserved.
ACORD 25(2016/03)' The ACORD name and logo'are registered marks of ACORD
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MSC#17755.
Aon Risk Services '
PO Box 1447
Lincolnshire;IL 60069 - ;
MDG2023 00001 945 01. '
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"II i11111111111,1111111111.11I11III'1111111llI''IINIIII'I1IIIIII
��ICity of Ashland . •
20 East Main Street •• , •
Ashland;OR 97520 "
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Certificate. No: 570100290339
ON
City of Ashland
20 East Main Street
Ashland OR 97520 USA.
Thursday, June 29, 2023
To whom it may concern:;
Following a concentrated effort to reduce our environmental footprintand provide timely certificate
delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format:
Please utilize one of the following methods to ensure you will receive the electronic copy of your
Certificate(Certificate No:;570100290339) for future renewals:
Visit aon.com/e-cert; or
- Utilize the QR Code below to enter/validate your information.
If your email address has changed or will be changing in the future, or you no longer require this
certificate, please let us know using one of the methods above.
Thankyou for your cooperation and willingness to help us reduce our impact to the environment:
MSC# 17755 I Aon
P.O. Box 1447
Lincolnshire, IL 60069
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