HomeMy WebLinkAboutInsurance Certificate: Century West Engineering Corp. .
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CENTWES-01 AIDDEHQAANZADA
ACORD® CERTIFICATE OF LIABILITYiINSURNCE • DATE(MM/DD/YYYX)
46.-----46.----- I A9/29/2020
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. '
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).
PRODUCERCONTACT } ,
NAME:
Alliance Insurance Group PHONE 541 687-4799 FAX
941 Oak St: (ac,No,Est):( ) '1(ac,No):(541)687-4718
Eugene,OR 97401 E-PAAI ss:info@allianceinsgrp.com
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Travelers Property Casualty Co.of America 36161
INSURED - INSURER B:Charter Oak Fire Insurance Company 25615 ,
Century West Engineering Corporation . INSURER C:Continental Casualty Company 20443
5331 SW Macadam Ave Ste 287 INSURER D: 1
Portland,OR 97239 - .1
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 NUMBER POLICY EFF POLICY EXP LIMBS
LTR INSD WVD (MM/DDIYYYY) (MM/DDIYYYY)
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
•
CLAIMS-MADE X OCCUR )( 680-2P616310-2047 10/1/2020 10/1/2021 pREMISP_s Ea occurrence) $ 1,000,000
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 JEOT X LOCPRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: I Total Aggregate $ 16,000,000
B AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT 1,000,000 •
I (Ea accident) $
X ANY AUTO BA-0R004108-2047-G 10/1/2020 10/1/2021 BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
HIRED NON-OWNED 1 PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY I. ' (Per accident) $
$
A X UMBRELLA UAB X OCCUR • I EACH OCCURRENCE _$ 5,000,000
EXCESS LIAR CLAIMS-MADE CUP-2P620789-20-47 10/1/2020 10/1/2021AGGREGATE $ 5,000,000
DED X RETENTION$ 10,000 1 $
•
WORKERS COMPENSATION
AND'EMPLOYERS'LIABILITY Y/N 1 STATUTE ERH
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $
- - If yes,des(xibe undef- - -- - - - --- ----- - -- -- : _ =---- - -- -- - -- .
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
C Professional Liab. AEH591913833 ' 10/1/2020 10/1/2021 Ea Claim&Aggregate ' 5,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If mare space Is required) .
City of Ashland is included as an Additional Insured as respects to General Liability. •
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City• of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Public Works - ,
20 East Main Street 1
Ashland,OR 97520 AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) I@ 1988=2015 ACORD CORPORATION. All rights reserved.
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