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HomeMy WebLinkAboutInsurance Certificate: Pro Turf Int'l LLC -------n"111 ® DATE(MM/DD/YYY1� A`� CERTIFICATE OF LIABILITY INSURANCE 07/18/2023 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. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)most 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 CONTACT Hart Insurance Agency PHONE Julie A Maphet FAX PO Box 1240 IANC,No Ext); I (541) 479-5521 (AIC,No): E-MAIL r Grants Pass OR 97528 ADDRESS: 1jmaphet@hartinsurance.com 1 INSURER(S)AFFORDING COVERAGE NAIC#' INSURER A:Developers Surety and Indemnity 12718 INSURED INSURER B:State National Ins Co Inc 12831 Pro Turf International, LLC INSURER C: 2305-C Ashland St. #178 INSURERD: ' Ashland OR 97520 INSURER E: ` (541) 890-6446 INSURER F: COVERAGES JM CERTIFICATE NUMBER:Cert ID 26571 1 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 LTR ,INSD.WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) B X i COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 1 AMAGE TO RENTED CLAIMS-MADE X OCCUR Y Y HLM51CL0434145 09/01/2023 09/01/2024 PREM SES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 ' PERSONAL&ADV INJURY $ 1,000,000 . GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JEC LOC PRODUCTS-COMP/OP AGG $ INCLUDED OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B ANY AUTO HLM51CL0434145 09/01/202309/01/2024 BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) r $ UMBRELLALIAB OCCUR I _EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ I $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMB ER EXCLUDED? (Mandatory in NH) E.L.DISEASE-Ely EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Contractors Bond 251166C 03/17/2023 03/17/2025RSC, Bond $ 15,000 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Blanket additional insured status with waiver of subrogation on a primary/non-contributory basis for General Liability as required by written contract per MP9767 10/10. Project Name: Omar's Median- Water Conservation Artificial Turf Pilot Project. i 1 I 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 Main Street ( AUTHORIZED REPRESENTATIVE i Ashland OR 97520 I I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered�marks of ACORD Page 1 of 1