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Home My WebLink AboutInsurance Certificate: Potelco, Inc.I Of 1 3795 ACORO� CERTIFICATE OF LIABILITY INSURANCE 5/1/202504/23/2024 ATE(MM/DD/YYYY) r 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 LOCKTON COMPANIES ONTACT NCAME 3657 BRIARPARK DRIVE, SUITE 700 HOUSTON TX 77042 PHONE FAX E-MAIL 866-260-3538 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Old Republic Insurance Company 24147 INSURED POTELCO, INC. INSURER B : ACE Property and Casualty Insurance Company 20699 INSURER C : 1364742 A QUANTA SERVICES COMPANY 14103 STEWART RD. SUMNER WA 98390 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 12424201 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N MWZY 313093 24 MWZX 313095 24 05/01/202 05/01/202 05/01/2025 05/01/202 EACH OCCURRENCE $ 5,000,000 PREMISES (Ea occu�rence) $ 1,000,000 MED EXP (Any oneperson) $ Excluded GEN'L PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY❑ ECT LOC OTHER: GENERAL AGGREGATE $ 5 000 000 PRODUCTS - COMP/OP AGG $ 5,000,000 $ A A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS AUTOS ONLY HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Y N MWTB 313092 24. MWZX 313091 24 05/01/202 05/01/202 05/01/202 05/01/202 Ea acccideDtSINGLE LIMIT $ 5,000,000 X BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY AMAGE Per accident $ XXXXXXX $XXXXXXX B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N XOO G27972032 009 05/01/202 05/01/202 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DIED I I RETENTION $ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A AI I V MWC 313094 24 05/01 /202 05/01 /202ER X - .L. EACH ACCIDENT E.L. 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations General Liability And Auto Liability Policies Include The City Of Ashland, Oregon, And Its Elected Officials, Officers And Employees As An Additional Insured When Required By Written Contract But Only As Respects Liability Arising Out Of Named Insured's Work For Additional Insured. %-rm I Ir-II+A l c. nULUr-M t PkNVCLLA 1 IUIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12424201 T17 P1 AUTHORIZED REPRESENTATIVE The City Of Ashland, Oregon Attn: Kari Ann Olson 90 N. Mountain Ave. Ashland OR 97520 rese ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD May 1, 2024 Re: Quanta Services and all Subsidiaries Renewal Certificate of Insurance Dear Certificate Holder: Enclosed for your records you will find the renewal Certificate of Insurance for Quanta Services and its Subsidiaries. To expedite the delivery of future renewal certificates, we are collecting email addresses for all certificate holders. Please note that if no email address is on file, we will continue to mail a certificate of insurance to the mailing address on file. If you wish to receive E-mail version of renewal certificates going forward, please send the email address at which you would like to receive your certificate as well as the Certificate Holder number (see below for directions on how to locate this information) to the following email address: Houston-QuantaECertDeliverv@lockton.com Certificate Holder # 12345678 12345678 1W SAMPLE 123 Main Street Anywhere AL 12345 .ORD 25 12019/031 Regards, Amy Barnett The Certificate Holder number is the 8 digit number directly above the Certificate Holder name and address in the bottom left corner of your enclosed COI.