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HomeMy WebLinkAboutInsurance Certificate: Cornforth Consultants Inc. • Client#:320005 CORNFCON • DATE(MM/DD/YYYY) A'CORD,. CERTIFICATE OF LIABILITY INSURANCE 10/26/2023 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. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT NAME: Please see below USI Insurance Services NW PR • PHONE 206'441-6300 FAX 610-362-8530 • (A/C,No,Ext): i (AIC,No): ' 60.1 Union.Street,Suite 1000 E-MAILESS: eaSttle.PLCertRe, uest usi.com ADDR �l Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIC# • INSURERA:Hartford Underwriters Insurance Company 30104 INSUREDINSURER B:Twin.City Fire Insurance Company 29459 Cornforth Consultants,Inc. INSURER C:Berkley Insurance Company 32603 • 10250 SW Greenburg Rd.,Suite 111 • Certain Underwriters at Flo ds 1122 • •Portland;OR 97223-5460 INSURER D: y 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 OFj 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. LTR TYPE OF INSURANCE NSRLSUBR WVD POLICY NUMBER WPOLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YY) . A X COMMERCIAL GENERAL LIABILITY . X X 52SBABA70AJ 11/01/2023 11/01/2024 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR PREMISES(Eaoccu ence) $1,000,000 . MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO • - POLICY X JECT LOC PRODUCTS-COMP/OPAGG $4,000,000 — OTHER: $ A AUTOMOBILE LIABILITY X X 52UECCL0526 11/01/2023 11/01/2024 COMBIaaccideNEDnt)SINGLE LIMIT 1,000,000 (E X ANY AUTO _ • BODILY INJURY(Per person) $ OWNED SCHEDULED ' ( BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X AUTOS ONLY X AUUTOS ON Y (Per PROacEcident)AMAGE $ I UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ • EXCESS LIAB CLAIMS-MADE AGGREGATE $ • DED RETENTION$ $ B WORKERS COMPENSATION, X 52WBCBA6ZXJ 11/01/2023 11/01/2024 X STATUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000. OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) , E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under 4 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 . C Prof.Liability 1 X AEC907167908 11/01/2023 11/01/2024 $2,000,000 per claim . (Incl.Pollution) $4,000,000 annl aggr. D Cyber Liab. KD930YLA230 11/01/2023 11/01/2024 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE: Project Name:CCI Job No.3074-2023 Hosier Dam Pat 12 Comprehensive Assessment,Ashland,OR. • The Professional Liability policy provides a Waiver of Subrogation when required by written contract. Should the Professional Liability policy be cancelled before the expiration date thereof,notice will be delivered in accordance with the policy provisions. . CERTIFICATE HOLDER CANCELLATION CityI of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE AshlandTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street . ACCORDANCE WITH THE POLICY PROVISIONS. •Ashland,OR 97520 AUTHORIZED REPRESENTATIVE r I t=r.. —a, gy�� - - • • ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03), 1 of 1 The ACORD name and logo are registered marks of ACORD - • . #S42401658/M42399861 SAPZR 1 This page has been left blank intentionally. • Policy Number:AEC907167908 Berkley. Insurance Company Architects, Engineers & Consultants Professional Liability J Contractor's Pollution Liability' Cyber Liability Media and Personal Injury Liability NOTICE: THIS IS A CLAIMS MADE. AND REPORTED IN WRITING POLICY. SUBJECT TO ITS .PROVISIONS,COVERAGE APPLIES ONLY TO CLAIMS THAT ARE FIRST MADE AGAINST THE INSURED DURING A POLICY YEAR AND FIRST REPORTED TO US IN WRITING WITHIN THAT SAME POLICY YEAR, . OR WITHIN ONE HUNDRED AND TWENTY (120) DAYS AFTER THE END OF SUCH POLICY YEAR, UNLESS AN OPTIONAL EXTENDED REPORTING PERIOD APPLIES. THIS POLICY CONTAINS PROVISIONS THAT LIMIT THE AMOUNT OF CLAIM EXPENSES THE COMPANY IS RESPONSIBLE TO PAY IN CONNECTION WITH CLAIMS. THE PAYMENT OF CLAIM EXPENSES WILL REDUCE THE LIMITS OF LIABILITY STATED IN ITEM 3 OF THE DECLARATIONS. • PLEASE READ THE POLICY CAREFULLY. The words"we,""us"and "our`mean the Insurance Company listed in'the Declarations'Page of this Policy. The words'you" and"your"mean any person or entity described in the definition of Insured. Words in bold print have special meanings defined • in Section VI.Definitions. In consideration of the payment of the Policy premium stated in Item 5 of the Declarations,and subject to all the terms,and in reliance upon the statements made in the application,which either is attached to this Policy or shall be deemed attached to this Policy by this provision,we.agree with you as follows: I. Insuring Agreements ' We will pay up to the Limits of Liability and subject to the Deductible stated in the Declarations all sums that the Insured becomes legally obligated to pay as Damages and Claim Expenses resulting from a Claim first made against the Insured during the Policy Year and first reported to us in writing during the same Policy Year,or within 120 days after the end of such. Policy Year,provided that A. Architects and Engineers Professional Liability _ 1. The Claim arises out of a Wrongful Act in, or Pollution Incident from,.the performance of your Professional Services; 2. The Wrongful Act Pollution Incident took place on or after the Retroactive Date stated in the.Declarations and before the end of the same Policy Year the Claim was first made;and 3. Prior to the Knowledge Date stated in the Declarations, none of the Principal Insureds knew or could have reasonably expected that any subject'Professional Services might give rise to a Claim, B. Contractor's Pollution Liability 1. The Claim arises out of a Pollution Incident from the performance of your Contractor Services; 2. The Contractor Services took place on or after the Retroactive.Date stated in the Declarations and before the end Of the same Policy Year the Claim Was first made;and • 3. Prior to the Knowledge Date stated in the'Declarations, none of the Principal Insureds knew or could have reasonably expected that any subject Contractor Services mightgive rise to a Claim. C. Cyber Liability 1. The Claim arises out of a Wrongful Act in the performance of your Professional Services and that: a is specifically related to Information Technology,Services;or b. results in the failure of Information Technology Products to perform the function or serve the purpose intended;-or � c. results in a Cyber Security Breach and BDP0417001 • . Page 1 of 9 . • BERKLEY INSURANCE COMPANY 2. The each Claim limit shown in Item 3A of the Declarations is the most we will pay for the sum of all Damages and Claim Expenses arising out of any single Claim. Two or more Claims considered a single Claim shall collectively be subject to the each Claim limit of liability shown in Item 3A of the Declarations. 3. The each Claim limit is the most we will pay for the sum of all Damages and Claim Expenses arising out of any single Claim regardless of how many Insuring Agreements may apply to such Claim. 4. The Policy Year Aggregate limit shown in Item 3B of the Declarations is the most we will pay for the sum of all Damages and Claim Expenses for all Claims made and reported during each Policy Year. 5. The payment of Damages and Claim Expenses will reduce the each Claim limit. F. Deductible • You must pay the Deductible for Claim Expenses and Damages covered by this Policy before we are obligated to make any payment under the each Claim limit. The Deductible must be paid from your own account,and payments by other parties or insurers on your behalf shall not satisfy, the Deductible. We have the right to determine the reasonableness of Claim Expenses that qualify to satisfy the Deductible. The Deductible for each Claim is set forth in Item 4A of the Declarations. The Policy Year Aggregate Deductible shown in Item 4B of the Declarations is the most the Named Insured must pay as a Deductible for the sum of all Claims made and reported during each Policy Year. G. Deductible Credits 1. Mediation Credit Your Deductible obligation may be reduced by 50%,subject to a maximum reduction of$15,000 if you agree with our decision to use Mediation and the Claim is fully and finally resolved by such Mediation. 2. Risk Management Credit Your Deductible obligation may be reduced by 50%,subject to a maximum reduction of $25,000 if prior to the report date of a Claim, there is a signed, written and enforceable agreement for the Professional Services involved in the Claim,and it includes a clause limiting your liability to$250,000 or less. 3. First Claim Deductible Credit If the first Claim you ever report to us is made against you: a. Greater than 24 months after the Knowledge Date shown on the Policy Declarations,then your Deductible obligation for that Claim may be reduced by 25%,subject to a maximum reduction of$40,000;or b. Greater than 36 months after the Knowledge Date shown on the Policy Declarations,then your Deductible obligation for that Claim may be reduced by 50%,subject to a maximum reduction of$40,000. If more than.one Deductible Credit applies,your Deductible obligation will be reduced by 50%,subject to a maximum reduction of$50,000. H. Notice of Cancellation and Nonrenewal This Policy may be canceled by the Named Insured identified in the Declarations,by surrender of the Policy to us or our authorized representative or by giving us written notice stating when,thereafter,such cancellation shall be effective. We will not cancel this Policy except for nonpayment of premium,fraud or material misrepresentation in procuring this insurance or in relationrto any Claim,or changes in law affecting this Policy. If we cancel this Policy,we will mail or deliver to the first Named Insured,on behalf of all Insureds,written notice of cancellation. We will provide you at least ten(10)days-notice before the effective date of cancellation,if we cancel for nonpayment of premium. If we cancel for any other reason,we will provide at least sixty(60)days-notice before the effective date of cancellation. If this Policy is canceled,we will send the first Named Insured any premium refund due. The refund will be pro rata. The cancellation will be effective even if we have not made or offered a refund. We will give you written,notice sixty(60) days prior to the expiration of this Policy if we do not intend to renew this insurance subject to any state requirements. The notice will include our reason for nonrenewal. Proof of mailing will be sufficient proof of notice. I. Other Insurance If there is other collectible insurance,including but not limited to other professional liability insurance or project specific insurance,that applies to a Claimcovered by this Policy,the other insurance shall be primary and this Policy shall be excess over the other insurance,unless the other insurance is written specifically excess of this Policy. This Policy will then applyto the amount of the Claim that exceeds the available limits of liability and any deductibles or retention amounts ofthe other insurance,as well as the Deductible under this Policy. If such other insurance has a duty to defend a Claim or assumes the defense of a Claim,this Policy shall not be obligated to defend that Claim. Cr.) Subrogation In the event of any payment under this Policy,we shall be subrogated to all of your rights of recovery against any person or organization. You must do everything reasonably necessary to secure such rights and must do nothing after a Claim is made to jeopardize them. We hereby waive our subrogation rights against a client of yours to the extent that you had,prior to a Claim or Circumstance,entered into a written agreement to waive such rights. Any recovery shall first be paid to us up to the extent of any Damages or Claim Expenses paid by us and the balance shall be paid to.you. K. First Named Insured as Sole Agent The first Named Insured.in Item 1 of the Declarations will be the sole agent and will act on behalf of all Insureds for the payment or return of premium, receipt and acceptance of any endorsements, notices or provisions of this Policy, giving or receiving notice of cancellation or nonrenewal, the payment of any Deductibles, and to exercise the rights provided in Section Q Extended Reporting Period Option. L. Alteration and Assignment • BDP0417001 Page 8 of 9