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Home My WebLink AboutInsurance Certificate: PumpTech, LLC and Frost Engineering, Division of PumpTech LLC (2)Page 1 of 2 ACC?RL?� DATE (MM/DDtYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/01/2024 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 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 endorsements . PRODUCER CONTACT WrW certificate Center NAME: Milli■ Towers Matson Northeast, Inc.FAX c/o 26 Century Blvd PHONE 1-877-945-7378 A/C No: 1-868-467-2378 P.O. Box 305191 E-MAIL certificates@wtwco.eom Nashville, TN 372305191 USA INSUREII AFFORDING COVERAGE NAIC# INSURED PumpTsch, LLC Frost &ngineerinq, Division of Pump Tech LLC 12020 SB 32nd St, Suite 2 Bellevue, NA 98005 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURERS: Travelers Indemnity Company of CT 25682 INSURERC: Travelers Property Casualty Company of Ana25674 INSURERO: Underwriters at Lloyd's London 15792 r_nVFRAr;FC rFRTIFIrATF NIIURFR- W35439048 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. IN TYPETYPE OF INSURANCE _ Af7bL:8U�R EE - - -- - - POLICY NUMBER MM�DYYYY ` MM IDnYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 S 300, 000 CLAIMS -MADE X OCCUR PREMISES Ea ocwrrence A MED EXP (Any one person) 1 $ 5,000 $ 1,000,000 Y Y-630-331D063A-COF-24 08/26/2024 08/26/2025 1 PERSONAL 8 ADV INJURY g 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE X � POLICY X JET LOC PRODUCTS - COMP/OP AGO Is 2,000,000 $ OTHER- AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT Ea accident) $ 1,000,000 i $ X ANY AUTO BODILY INJURY (Per person) 8 OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 810-1Y037218-24-14-G ' 08/26/2024 08/26/2025 i BODILY INJURY (Per accident) PROPERTY DAMAGE 1I _jPer accidence $ $ is C UMBRELLA LIAB X OCCUR • X EXCESS LIAB CLAIMS -MADE tSX-4Y788505-24-14 08/26/2024 EACH OCCURRENCE OS/26/2025',AGGREGATE $ 10,000,000 g 10,000,000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C OFFICEWMEMBEREXC UDED?ECUTIVE Y� No NIA (Mandatory In NH)(Mandatory In NH)�E.L. UB-4Y056146-24-14-G 08/26/2024 X STATUTE ER 08/26/2025' E.L.ACH ACCIDENT - - - -- DISEASE • EA EMPLOYEEI • EA EMPLOYEE$ $ 1,000,000 l $ $DISEASE 1,000,000 i $ 1, 000, 000 II yes. de5aribe under DESCRIPTION OF OPERATIONS below � E.L. DISEASE � POLICY LIMIT D Professional Liability B0621PDAK0001724 09/26/2024108/26/2025'Sach Claim 1$2,000,000 Aggregate 1$2,000,000 i DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) The General Liability policy above included NA Stop Gap $IN / $1N1 / $IN. SSE ATTACHED 6itri 1 It-II:A 1 t MULUCM I+AIvli C1.LA 11WI1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE City of Ashland 20 East Main St Ashland, OR 97520 ® 1988-2015 AGURU CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD all ID: 26511272 sATca: 3642217 7331: 2 ` of 3 ACCWV AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY Willis Towers Watson Northeast, Inc. POLICY NUMBER See Page 1 CARRIER See Page 1 NAMED INSURED PumpTech, LLC frost Engineering, Division of PumpTsch LLC 12020 SE 32nd St, Suite 2 Bellevue, WA 98005 NAIC CODE See Page 1 EFFECTIVE DATE: See Page 1 Page 2 of 2 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability insurance The City of Ashland, Oregon, and its elected officials, officers and employees is/are an Additional Insured to the extent provided by the policy language or endorsement issued or approved by the insurance carrier. INSURER AFFORDING COVERAGE: Underwriters at Lloyd's London NAIC#: 15792 POLICY NUMBER: B0621PDAK0002524 EFF DATE: 09/26/2024 EXP DATE: 08/26/2025 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Professional Liability Each Claim $1,000,000 Aggregate $1,000,000 ACORD 101 (2008/01) W ZUkW Al-UMU UUMI`VKA I IUrv. Ali ngni5 re5erveu. The ACORD name and logo are registered marks of ACORD SR ID:26511272 SATCH:3642211 CERT: W35439048 7331: 2 of 3 1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect: and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury' or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the 'occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the 'occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CIS D2 46 0419 0 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 7331: 3 ' of 3 i COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 V 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 0419 7331: 3 WILLIS TOWERS WATSON 26 CENTURY BLVD. 6TH FL, SUITE 101 NASHVILLE, TN 37214 7331 1 MB 0.617 7331 II��II�III�I�'I�'ICI'll��l��lll�lllll�'�II�I�I�IIII�I��"��I��I' CITY OF ASHLAND 20 E MAIN ST ASHLAND, OR 97520-1814 7331: 1 ' of 3