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HomeMy WebLinkAboutInsurance Certificate: Osmose Utilities Services, Inc.CERTIFICATE OF LIABILITY INSURANCE DATEO(68/Do24YY) 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 Aon Risk services central, Inc. MSc# 17385 Aon PO BOX 1447 CONTACT NAME: PHONE (A/C. No. Ext): (866) 283-7122 (FAX No.): (800) 363-0105 E-MAIL ADDRESS: Lincolnshire IL 60069 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED osmose Utilities services, Inc. 635 Highway 74 S Peachtree City GA 30269 USA INSURER A: Old Republic insurance Company 24147 INSURERS: Starr indemnity & Liability company 38318 INSURER C: INSURER D: INSURER E: INSURER F: 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. Limits shown are as requested LTA TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY MWZY EACH OCCURRENCE $2 , 000, 000 CLAIMS -MADE X❑ OCCUR PREMISES Ea occurrence)$2 , 000 , 000 MED EXP (Any one person) $ 5 , 000 PERSONAL& ADV INJURY $2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $4,000,000 X POLICY LOC PRODUCTS - COMP/OPAGG $4,000,000 JECTPRO- OTHER: A AUTOMOBILE LIABILITY MWTB 315620-24 07/01/2024 07/01/2025 COMBINED SINGLE LIMIT Eaaccident) $5,000,000 BODILY INJURY ( Per person) X ANY AUTO OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) AUTOS ONLY HIRED AUTOS NON -OWNED PROPERTY DAMAGE ONLY AUTOS ONLY Per accident B UMBRELLA LIAB H OCCUR 1000095518241 07 01 2024 07 01 2025 EACH OCCURRENCE $5,000,000 XIDED EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000 RETENTION A WORKERS COMPENSATION AND MWC 1561 24 07 01 0 4 07 Ol 0 5 X PER STATUTE OTH- EMPLOYERS' LIABILITY Y / N ER E.L. EACH ACCIDENT $1 , 000 , 000 ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 E.L. DISEASE -POLICY LIMIT $1, 000, 000 DESCRIPTION OF OPERATIONS below i i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) I The City of Ashland, Oregon, and its elected officials, officers and employees is included as Additional insured in accordance with the policy provisions of the General Liability & Automobile Liability policies. The General Liability insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions and where required by written contract. A waiver of Subrogation is granted in favor of certificate Holder in accordance with the policy provisions of the General Liability policy. i I GI_M I II-Il:AI t MUL.Lttrs CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Ashland AUTHORIZED REPRESENTATIVE •�; 20 East Main street Ashland OR 97520 USA v ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Certificate No: 570106454620 City of Ashland 20 East Main Street Ashland OR 97520 USA Tuesday, June 18, 2024 To whom it may concern: SON Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570106454620) for future renewals: - Visit aon.com/e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. Aon Risk Services 5801 Postal Road PO Box 818037 Cleveland, Ohio 44181-9600 a