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HomeMy WebLinkAboutInsurance Certificate: Electrical Consultants, Inc • �....445 ELECCON-05 RDYER '4C RL CERTIFICATE OF LIABILITY INSURANCE DATE 10/29IDDIYYYY) 10/29/2019 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 CONTACT NAME: Billings Office PHONE FAX (A/c,No,Ext):(406)238-1900I(A/C,No):(406)245-9887 PayneWest Insurance,Inc. E-MAIL P.O.Box 30638 _ADD_RESS: Billings,MT 59107-0638 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:National Fire Insurance Co of Hartford 20478 INSURED INSURER B:Continental Casualty Company 20443 Electrical'Consultants,Inc. INSURER C:Continental Insurance Company 35289 3521 Gabel Road INSURER D:Zurich American Insurance Company 16535 Billings,MT 59102-7307 INSURER E:Montana State Fund 15819 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 LIMITS LTR INS° WVD (MMIDD/YYYY) (MMIDD/YYYY1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X 6015980113 11/1/2019 11/1/2020 °PREMISES EaoNccjuencey $ 300,000 ' MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PE 0 X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 6014516577 • 11/1/2019 11/1/2020 BODILYINJURY(Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ ITNON-OWNED PROPERTY ONLY _ TS (Per accident) $ $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000 EXCESS LIAB CLAIMS-MADE 6015980127 11/1/2019 11/1/2020 AGGREGATE $ 15,000,000 DED X RETENTION 10,000 $ D WORKERS COMPENSATION YIN WC959744508 1/1/2019 1/1/2020 •X STATUTE ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 E yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Professional/Polluti AEH114043145 9/10/2019 9/10/2020 Each Claim/Aggregate 10,000,000 E Montana Work Comp 032578445 1/1/2019 1/1/2020 Per Statute/EL Limit 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers Comp Information for MT:Montana State Fund policy#032578445 Eff 01/01/19-01/01/20 Coverage A Statutory Employers Liability Limits for Policy: Each Accident:$1,000,000/Disease-Each Employee:$1,000,000/Disease-Policy Limit CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street . Ashland,OR 97520 AUTHORIZED REPRESENTATIVE DR I ae---49 • ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NORTHLAND INSURANCE COMPANY C/O CRC GROUP 2965 EAST TARPON DRIVE, #130 MERIDIAN ID 83642 REINSTATEMENT NOTICE Named Insured&Mailing Address: Producer:CRP00406 FIELD TRANSPORTATION, INC. CHOICE ONE INSURANCE,INC. 10815 SW 135TH AVE 9111 SE SAINT HELENS STREET BEAVERTON OR 97008 CLACKAMAS OR 97015 — I Policy No.: WN253493 _ I Type of Policy: AUTO LIABILITY, PD&MOTOR TRUCK CARGO You recently received a notice advising this policy was being cancelled effective 11/26/2019 . This notice is to advise that the policy is being reinstated without lapse in coverage. • Date Mailed: 28th day of October, 2019 Additional Insured i . amu CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND OR 97520 PETE FEENEY ORCT1 FORM#CT9698970R51995 10282019SINY ODEN 3.0.19.10a Copy for Additional Insured Page 1 of 1