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HomeMy WebLinkAboutInsurance Certificate: Timberline Logging Enterprises, LLCClient#: 2035102 TIMBEHEI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 1/22/2025 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 Logging Enterprises, LLC 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 CLAIMS -MADE [* OCCUR BI/PD Ded:5,000 X 403BG0742702 05/15/2024 05/15/2025 EACH OCCURRENCE $1 ,000,000 PREMI6ESOEa oNcurrDence $100,000 X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1 ,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OPAGG $2,000,000 $ D AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY $1,000 X Comp/Coll. 01CA06614528410 01/24/2025 01/24/202 EeaBc,denSINGLELIMIT $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Pera ccident $ XDed: $ B UMBRELLA LAB EXCESS LAB OCCUR CLAIMS -MADE 29UD0199184014 01/24/2025 01/24/2026 EACH OCCURRENCE $5 000 000 X X AGGREGATE s5,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 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 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. 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 #S47906397/M47902171 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DGSZP