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HomeMy WebLinkAboutInsurance Certificate: AMUA Actuators Inc' � ® A� o CERTIFICATE'OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/3/2024 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.conditionsof 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 Arthur J. Gallagher Risk Management Services, LLC 1.Pasquerilla Plaza Suite 100 CON ACT NAME:. Josh Miller PHONE FAX E • 412-209-4428 A/c No:814-536-5554 E-MAIL ADOREss: 'osh millerl a' .com INSURERS AFFORDING COVERAGE NAIL # Johnstown PA 15901 INSURER A: HDI-Gfobal Insurance Company 41343 INSURED AUMAACT-02 INSURER .8 : Travelers Indemnity Company 25658 AUMA Actuators, Inc. 100 Southpointe Boulevard INSURER c : Charter Oak Fire Insurance Company 25615 -Canonsburg PA 15317 INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:8251041.01 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 LTR TYPEOFINSURANCE INSO W D POLICYNUMBER MM/DDNYY MM/DDNYYY LIMITS , A X COMMERCIAL GENERAL LIABILITY. CLAIMS -MADE F OCCUR Y GLD1066916 1/1/2024 1/1/2025 EACH OCCURRENCE $.1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 " MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑PRO- ElJECT LOC OTHER: GENERAL AGGREGATE $ 2.000,000 PRODUCTS - COMP/OP AGG $1,000;000 $ B AUTOMOBILE I•X X X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Y 13A9N74726723140 12/31/2023 12/31/2024 COa acINEDMBINED SINGLE LIMIT - E $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $. PROPERTY DAMAGE Per accident $ A X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE CUD1067016 1/1/2024 1/l/2025 EACH OCCURRENCE $4,000,000 AGGREGATE $ 4,000,000 DED I X I RETENTION $ in n n $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? a (Mandatory in NH) If as, describe under DESCRIPTION OF OPERATIONS below N/A UB9S9526832314G 12/31/2023 . 12/31/2024 X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more apace is required) The City of Ashland, Oregon, its officers, agents and employees are additional insured on the General Liability policy as perform #CG 20 10, edition 04/13 and on the Auto Policy as per form #CA T3 53, edition 02115. The Umbrella policy is follow form in regards to additional insured provision as per form #CU 00 01, edition 04/13. The Workers Compensation policy is Evidence of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD. ANY OF THE ABOVE DESCRIBED -POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE - THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE,POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 USA ©1988-2015 ACORD CORPORATION. All rights reserved.. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher Risk Management Services, LLC 1 Pasquerilla Plaza, Suite 100 Johnstown PA .15901 MDG2024 00012857 01 . Iy�111l111'IIIIIIJ'.II'lllIIIIIIInnJII1IInllllllllly .... City of Ashland 20 East Main Street Ashland, OR 97520 We'are.providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no :longer. require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no, longer required; or 2. E-mail address to send future certificates of .insurance in lieu of U.S. Mail delivery 3. lnsured Code:. AUMAACT-02. 4.. This Certificate Number: 825104101. To learn more, about the -Insurance and. Risk Management Services offered by Gallagher,' please visit us at www.gjg.com/us/about-us/how-we-work/core-360. Gallagher. does not share your e-mail.as detailed in our privacy policy foundat https:// www.ajg.com/us/privacy-;policy/. COMMERCIAL AUTO ,THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ`IT CAREFULLY. BUSINESS AUTO EXTENSION. ENDORSEMENT This, endorsement modifies insurance provided under the following:. BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This- endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement'may be excluded or " limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover= age description only. Limitations and exclusions may apply to these coverages. Read all the .provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H HIRED AUTO PHYSICAL DAMAGE —'LOSS OF B. BLANKET ADDITIONAL INSURED USE — INCREASED LIMIT 1. PHYSICAL DAMAGE — TRANSPORTATION C. EMPLOYEE HIRED AUTO EXPENSES - INCREASED LIMIT D. EMPLOYEES AS INSURED' J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO —. LIMITED WORLDWIDE COV- LOSS ERAGE = INDEMNITY BASIS M. 'BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE GLASS N. " UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD,FORM.NAMED INSURED The following is added t6:Paragraph A.1., Who Is, An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over: which you maintain 50% or more ownership interest and that is not separately insured for. Business Auto Coverage: Coverage under this provision is afforded only.un-, tll the 180th day after you acquire or form the or- ganization or the end of the,policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following. is added to Paragraph c. in. A.1., . Who Is An Insured, of SECTION If —,COVERED AUTOS LIABILITY COVERAGE: . Any person or organization who is required under a written contract or agreement between you and. that person or organization', that, is signed and executed by you before the "bodily injury" or, "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which . this insurance 'applies 'and only to the extent that person or organization qualifies as an "insured" under the Who_o Is An' Insured provision contained in Section IL C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph AA., Who Is An Insured, 'of SECTION II — COV- ERED AUTOS LIABILITY. COVERAGE: An -"employee" of -yours is an "insured"while operating an "auto hired- or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. ,. The following replaces Paragraph b. in B:5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS; b. For Hired Auto Physical Damage Cover- age, the following are deemed to be, cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow, and (2) Any covered "auto"`hired or rented by your "employee" under a contract in an "employee's name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity company: All, rights reserved. Page 1 of 4 Includes copyrighted material of Insurance services Office, Inc, with Its permission. C.* With respect -to the insurance afforded to these 2: Available under . the. applicable Limits of additional insureds, the following is added .to Insurance shown in the Declarations; Section III - Limits Of Insurance: whichever is less. If 'coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contractor agreement, the most we Limits of Insurance shown in the Declarations. will pay on behalf of the additional insured is the amount of -insurance: 1. Required by the contract or agreement; or EL N N N O O O O Page 2 of 2 0 Insurance Services Office, Inc., 2012 . • CG 2010 0413 POLICY NUMBER: GLD1066916 COMMERCIAL .GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY: PLEASE READ IT CAREFULLY. ADDITIONAL INSURED --OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON. OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organization( s Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION ANY LOCATION WHERE REQUIRED WHERE REQUIRED BY WRITTEN 'BY WRITTEN CONTRACT CONTRACT A. Section II - Who Is An Insured is amended to include' as an additional insured the person(s)'or organizations) shown in the Schedule; .but only` with respect to liability for "bodily injury", "property .damage" or "personal and advertising injury caused, in whole or in part; by: 1. Your acts or omissions;. or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing: operations 'for'. the additional insured(s) at, the locations) designated above. However: 1. The insurance afforded to , such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement the insurance afforded to such additional insured will not be broader than that'which you are -- required by the contract or agreement to provide for such additional Insured. - J $. With respect to the insurance afforded to these additional insureds, the . following, additional exclusions apply: This insurance does not apply to 'bodily injury" or "property damage" occurring after: 1. All work; including materials, parts or equipment furnished in connection with such work , on the project (other than service, maintenance or repairs) to be performed .by or on behalf- of the additional insureds) at the location of the covered operations has, been completed; or 2'. That portion of "your work" out of which the injury or .damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged, 'in performing operations for a principal as a part of the same project. CG 20100413. © insurance Services Office, Inc., 2012 Page 1of 2 POLICY NUMBER:' GLD1066916 COMMERCIAL GENERAL LIABILITY, C.G 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS,.LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART = . PRODUCTS/ COMPLET8D OPERATIONS LIABILITY COVERAGE PART+ SCHEDULE Name Of Additional Insured•Person(s) Or Organization( s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION WHERE REQUIRED BY WRITTEN CONTRACT ANY LOCATION WHERE REQUIRED BY WRITTEN CONTRACT information Emma to complete tnls 5cneaule, it not shown above, will be shown in the Declarations. J A. Section II - Who Is An Insured is amended to B. With respect to- the insurance afforded. to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown ' in the Schedule,' but only Section Ill = Limits Of Insurance: with respect to liability. for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we your work" at the location designated and, will pay on behalf of the additional insured .is the described in. theSchedule of, this endorsement ' amount of insurance: ' performed ,for that, additional insured and included in the "products -completed operations.' 1. Required by,the contract or agreemenjor hazard". 2. Available under the applicable Limits of However: ' Insurance shown.in the Declarations; 1. The ' insurance, afforded,. to such, additional whichever is less. insured only applies to the extent permitted by . This endorsement shall not increase the applicable law; and Limits of Insurance shown in the Declarations. 2. if coverage provided to the additional insured is required by.a contract or agreement, the insurance afforded -to such additional insured `will not bebroader than that which: you are required bythe contract or agreement- to. provide for such. additional insured., 0 CG 2017 0413 0 Insurance Services Office,, Inc.; 2012 Page 1 of