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HomeMy WebLinkAboutInsurance Certificate: Thornton Engineering Inc 0 DATE(MM/DD/YYYY) AC® CERTIFICATE OF LIABILITY INSURANCE 06/25/2020 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)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 doesnot confer rights to the certificate holder in lieu of such endorsement(s). . PRODUCER CONTACT . Hart-Insurance Agency - Medford PHONE' Tom Xaldunski FAX . ' PO Box 1240 (A/C.No.Extl: (541) 779-4232 - (A/C,No): ' E-MAIL . Grants Pass OR 97528 ADDRESS: 1kdolmage@hartinsurance.com i INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentinel Insurance Company LTD 11000 INSURED (541) 899-1489 INSURER B:SAIF Corporation 36196 Thornton Engineering Inc INSURER C:Travelers Casualty and Surety 31194 k PO Box 476 INSURERD: 'I Jacksonville OR 97530 • INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 16351 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) A X COMMERCIALGENERALLIABILITYEACH OCCURRENCE $ 2,000,000 AMAGE TO RETED CLAIMS-MADE X OCCUR Y 52SBANN9205 07/01• /2020 07/01/2021 PREM SES(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL BADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE $ 4,000,000 POLICY PRO- JECT LOC I • PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: ! $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) A • ANY AUTO 52SBANN9205 07/01/2020 07/01/2021 BODILYINJURY(Perperson) $ OWNED SCHEDULED ! BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS I HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) $ I $ UMBRELLA LIAB OCCUR I • EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ I $ WORKERS COMPENSATION IPER 0TH- B AND EMPLOYERS'LIABILITY YIN 910109 07/01/2020 07/01/2021 X STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE NIA i E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • C Errors and Omissions 105350491 10/01/2019 10/01/2021Each- Occurrence $ 2,000,000 C Errors and Omissions 105350491 10/011/201910/O1/2021Aggregate $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) certificate holder is additional insured per attached forms SS0008 04/05 and SS4175 09/15 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 'E Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 • '�✓ �/ 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 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED '3. Additional Insured -Grantor Of Franchise COVERAGES WHO IS AN INSURED under Section C. is If listed or shown as applicable in the Declarations, t amended to include as an additional insured one or more of the following Optional Additional the person(s) or organization(s) shown in the Insured Coverages also apply. When any of these Declarations as an Additional Insured - Optional Additional Insured Coverages apply, Grantor Of Franchise, but only with respect to Paragraph 6. (Additional Insureds When Required their liability as grantor of franchise to you. by Written Contract, Written Agreement or Permit) 4. Additional Insured - Lessor Of Leased of Section C., Who Is An Insured, does not apply Equipment to the person or organization shown in the a. WHO IS AN INSURED under Section C.is Declarations. These coverages are subject to the amended to include as an additional terms and conditions applicable to Business Insured the person(s) or organization(s) Liability Coverage in this policy, except as shown in the Declarations as an Additional provided below: Insured — Lessor of Leased Equipment, 1. Additional Insured - Designated Person Or but only with respect to liability for"bodily Organization Injury", "property damage" or "personal WHO IS AN INSURED under Section C. is and advertising Injury" caused, in whole or amended to include as an additional insured In part, by your maintenance, operation or the person(s) or organization(s) shown in the use of equipment leased to you by such Declarations, but only with respect to liability person(s)or organization(s). for "bodily injury", "property damage" or b. With respect to the insurance afforded to "personal and advertising Injury" caused, In these additional insureds, this insurance whole or in part, by your acts or omissions or does not apply to any"occurrence" which the acts or omissions of those acting on your takes place after you cease to lease that ' behalf: - equipment. a. In the performance of your ongoing 5 Additional Insured - Owners Or Other operations;or Interests From Whom Land Has Been b. In connection with your premises owned Leased by or rented to you. a. WHO IS AN INSURED under Section C.is 2. Additional Insured - Managers Or Lessors amended to include as an additional Of Premises insured the person(s) or organization(s) shown in the Declarations as an Additional a. WHO IS AN INSURED under Section C. is Insured—Owners Or Other Interests From -amended to include as an additional insured Whom Land Has Been Leased, but only •the person(s)or organization(s)shown in the with respect to liability arising out of the Declarations as an Additional Insured - ownership,"maintenance or use of that part Designated Person Or Organization;but only of the land leased to you and shown in the with respect to liability arising out of the Declarations. ownership,maintenance or use of that part of :the premises leased to you and shown in the b. With respect to the insurance afforded to Declarations. these additional insureds, the following b. With respect"tothe insurance afforded to additional exclusions apply: these additional insureds; the following • This insurance does not apply to: additional exclusions apply: • (1) Any "occurrence" that takes place This insurance does not apply to: after you cease to lease that land; or (1) Any "occurrence" which takes place (2) Structural alterations, new after you cease to be a tenant in that construction or demolition operations premises; or performed by or on behalf of such person or organization. (2) Structural alterations, new 6. Additional Insured - State Or Political construction or demolition operations performed by or on behalf of such Subdivision —Permits person or organization. a. WHO IS AN INSURED under Section C.is amended 'to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 1 BUSINESS LIABILITY COVERAGE FORM Insured — State Or Political Subdivision - (e) Any failure to make such Permits, but only with respect to inspections, adjustments, tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit. make in the usual course of b. "With respect to the insurance afforded to business, in connection with the these additional insureds, the following distribution or sale of the products; additional exclusions apply: (f) Demonstration, installation, This insurance does not apply to: servicing or repair operations, (1) "Bodily injury", "property damage" or except such operations performed "personal and advertising injury" at the vendors premises in connection with the sale of the arising out of operations performed for the state or municipality;or product; (2) "Bodily injury" or "property damage" (g) Products which, after distribution or sale by you, have been labeled included in the "product-completed or relabeled or used as a • operations"hazard. : -container, parror ingredient of any 7.., Additional Insured—Vendors other thing or substance by or for a. WHO IS AN INSURED under Section C. Is the vendor,or amended to include as an additional {h} "Bodily injury" or "property insured the person(s) or organization(s) damage" arising out of the sole (referred to below as vendor)shown in the negligence of the vendor for Its Declarations as an Additional Insured - own acts or omissions or those of Vendor, but only with respect to "bodily its employees or anyone else injury" or "property damage" arising out of acting on Its behalf. However,this "your products" which are distributed or exclusion does not apply to: sold in the regular course of the vendors ' (I) The' exceptions contained in business"and only if this Coverage Part Sub aro ra hs(d)or p 9 p (f);or provides coverage for "bodily injury" or (ii) Such inspections, "property damage" included within the "products-completed operations hazard". adjustments,tests or servicing • as the vendor has agreed to b. The insurance afforded to the vendor is make or normally undertakes subject to the following additional exclusions: to make in the usual course of (1); This insurance does not apply to: business, in connection with (a) "Bodily injury" or "property the distribution or sale of the damage" for which the vendor is products. obligated, to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement. whom you have acquired such __ This-exclusion does not apply to products, or any `ingredient, part or liability for damages that the container, entering into, vendor would have in the absence . accompanying or containing such of the contract or agreement; products. (b) Any express warranty 8. Additional Insured—Controlling Interest unauthorized by you; WHO IS AN' INSURED under Section C. is (c) Any physical or chemical change. .amended to include as an additional insured in the product made intentionally . . the person(s) or organization(s) shown In the by the vendor, Declarations as an Additional Insured — (d) Repackaging, unless unpacked Controlling Interest, but.only with respect to solely for the purpose of inspection, their liability arising out of: demonstration, testing, or the ' . a.- Their financialcontrol of you;or substitution of parts . under b. Premises they own, maintain or control instructions from the manufacturer, while you lease or occupy these premises. and then repackaged in the original container Form SS 00 08 04 05 Page 19 of 24 , BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional , alterations, newconstruction and demolition insureds are described in Section D. — Limits Of operations performed by or for that person or I 9surance. organization. How this insurance applies when other insurance • 9. Additional Insured-— Owners, Lessees Or isl available to an additional insured is described in' Contractors — Scheduled Person Or the Other ;Insurance Condition in Section E. — Organization Liability And Medical Expenses General a. WHO IS AN INSURED under Section C. is, Conditions. amended to include as an additional G. LIABILITY AND MEDICAL EXPENSES insured the person(s) or organization(s) ' fEFINITIONS shown in the Declarations as an Additional Insured—Owner, Lessees Or Contractors, 1. "Advertisement" means the widespread public but only with respect to liability for"bodily dissemination of information or images that injury", "property damage" or "personal has the purpose of inducing the sale of goods, and advertising injury" caused, in whole or productsor services through: in part,, by your acts or omissions or the a. (1) Radio; acts or omissions of those acting on your (2) Television;� behalf: (3) .Billboard; (1) In the performance of your ongoing (4) Magazine; operations for the additional insured(s);or (5) Newspaper, (2) In connection with "your work" b. The Internet, but only that part of a web performed for that additional insured site that is about goods, products or and included within the "products- services for the purposes of inducing the completed operations hazard", but sale of goods, products or,services;or only if this Coverage Part provides c. Any' other publication that is given coverage for "bodily injury" or widespread public distribution., "property damage" included within the However,"advertisement"does not include: hproducts-completed operations azard a. The design, printed material, information • or images contained in, on or upon the b. With respect to the insurance afforded to packaging or labeling of any goods or these additional insureds, this insurance products; or does not apply to"bodily injury", "property damage" or "personal an advertising b. An interactive conversation between or injury".arising out of the rendering of, or among persons through a computer network. the failure to render, any professional 2 "Advertising idea" means any idea-for an architectural, engineering or surveying "advertisement". services, including: , 3 "Asbestos hazard" means an exposure or (1) The preparing, approving, or failure to threat of exposure to the actual or.alleged prepare or approve, maps, shop properties of asbestos and includes the mere ••. drawings, opinions, reports, surveys, I presence of asbestos in any form. field orders, change orders, designs or 4. "Auto" means a land motor vehicle,trailer or drawings and specifications;or I semi-trailer designed for travel on public (2) Supervisory, inspection, architectural roads, including any attached machinery' or or engineering activities. equipment. But "auto" does not include 1 10. Additional Insured — Co-Owner Of Insured "mobile equipment". Premises 5. "Bodily injury"means physical: WHO IS AN INSURED' under Section C. is a. Injury; 'amended to include•as an additional insured b." Sickness;or. the person(s) or Organization(s) shown in the c. Disease. Declarations as an- Additional Insured — Co- Owner Of Insured Premises, but only with •sustained by a person and, if arising out of the respect to their liability as co-owner of the above, mental anguish or death at any time. premises shown in the.Declarations. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05 1 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PROVISIONS This endorsement modifies insurance provided under the,following: BUSINESS LIABILITY COVERAGE FORM A. It is agreed that paragraph (2) of subsections 6.d. COVERAGES; and it is agreed the following and 6.f. of Section C. - WHO IS AN INSURED is paragraphs replace section b. of subsection 9. of replaced by the following: Section F. - OPTIONAL ADDITIONAL INSURED (2) The insurance afforded by paragraph (1) COVERAGES. These paragraphs do not attach or above does not apply if the additional amend the language of any of the other subsections insured's acts or omissions, or the acts or of Section F - OPTIONAL ADDITIONAL INSURED omissions of those acting on additional COVERAGES: insured's behalf, that are alleged to have The insurance afforded by this subsection does caused the "bodily injury", "property not apply if the additional insured's acts or damage" or "personal and advertising omissions, or the acts or omissions of those injury", involve professional architectural, acting on the additional insured's behalf, that engineering or surveying services, including are alleged to have caused the "bodily injury", but not limited to: "property damage" or "personal and advertising (a) The preparing, approving or failure to injury", involve . professional architectural, prepare or approve, maps, shop engineering or surveying services, including but drawings, opinions, recommendations, not limited to: reports, surveys, field orders, change (a) The preparing, approving or• failure to orders, designs or drawings and prepare or approve, maps, shop drawings, specifications, or I opinions, recommendations, reports, (b) Supervisory, inspection, quality control, surveys, field orders, change orders, architectural or engineering activities. i designs or drawings and specifications, or This limitation applies even if the claims (b) Supervisory, inspection, quality control, against the additional insured allege architectural or engineering activities. negligence or other wrongdoing- in the This limitation applies even if the claims supervision, hiring, employment, training or against the additional insured allege monitoring of others by the additional negligence or other wrongdoing in the insured. supervision, hiring, employment, training or (3) The insurance afforded to such additional monitoring of others by the additional insured: insured. (a) Only applies to the extent permitted by The insurance afforded to such additional law; and insured: (b) Will not be broader than that which you (a) Only applies to the extent permitted by law; are required by the contract or and agreement to provide for such (b) Will not be broader than that which you are additional insured. required by the contract or agreement to B. It is agreed that the following paragraphs are added provide for such additional insured. to the end of subsections 1. and 8. of Section F - OPTIONAL ADDITIONAL INSURED Form SS 41 75 09 15 Page 1 of 1 © 2015,The Hartford