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HomeMy WebLinkAboutInsurance Certificate: Timberline Helicopters, Inc.Client#: 2035102 TIMBEHEI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 12/23/2024 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services NW CL 601 Union Street, Suite 1000 Seattle, WA 98101 CONTACT Kassi Johnson NAME: PHONE 206 441-6300 FAX 610-362-8530 MA Lo, Ext : (A/C, No): ADDRESS: kassi.johnson@usi.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Burlington Insurance Company 23620 INSURED Timberline Helicopters, Inc. 1926 Industrial Dr Sandpoint, ID 83864 INSURER B : National Union Fire Ins Co of Pitts, PA 19445 INSURER C:Starr Indemnity and Liability Company 38318 New Hampshire Insurance Company INSURER D : p P y 23841 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 CONTRACTOR 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 ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 403BG0742702 05/15/2024 05/15/2025 EACH OCCURRENCE $1 ,000,000 CLAIMS -MADE [* OCCUR PREMI6ESOEa oNcurrDence $100,000 X MED EXP (Any one person) $ 5,000 BI/PD Ded:5,000 PERSONAL & ADV INJURY $1 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ECT LOC PRODUCTS-COMP/OPAGG $2,000,000 $ OTHER: D AUTOMOBILE LIABILITY 01CA0661452849 01/24/2024 01/24/202 EeaBc,denSINGLELIMIT $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Pera ccident $ X HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY XDed: $ $1,000 X Comp/Coll B UMBRELLA LAB OCCUR 29UD0199184013 01/24/2024 01/24/2025 EACH OCCURRENCE $5 000 000 X X AGGREGATE s5,000,000 EXCESS LAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N / A X 1001243082 01/01/2025 01/01/2026 X STATUTE EERH E.L. EACH ACCIDENT $1 ,000,000 E.L. DISEASE - EA EMPLOYEE $1 ,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement are Additional Insured as it relates to General Liability and Auto Liability when required by written contract or written agreement in place and in accordance with the terms and conditions of the policy. Coverage is Primary and non-contributory. Additional Named Insured: Timberline Helicopters Inc. Loggers Division CERTIFICATE HOLDER CANCELLATION City of Ashland 20 East Main Street Ashland, OR 97520 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 ACORD 25 (2016/03) 1 of 1 #S47468417/M47438143 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AZLZP This page has been left blank intentionally.