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HomeMy WebLinkAboutInsurance Certificate: Coleman Creek Consulting IncDATE (MM/DD/YYYY) A� " CERTIFICATE OF LIABILITY INSURANCE 03/31/2025 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Hart Insurance Agency - Medford PHONE Rristi Dolmage FAX PO Box 1240 E-MAIL Ext: (541) 779-4232 AIC No: Grants Pass OR 97528 ADDRSS: kdolmage@hartinsurance.com INSURED Coleman Creek Consulting Inc 810 Leonard Street Ashland OR 97520 COVFRAOFS xD CERTIFICATE NUMBER: Cert ID 31613 (36) REVISION NUMBER: 24082 24856 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 OF INSURANCE ADDLTYPE INSD SUER POLICY NUMBER MOL pY EFF MMIDDY FxP LIMITS g X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE I —XI OCCUR Y FEIECC13827 03/18/2025 33/18/2026 AMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 , 000 , 000 S POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Professional Liabi!S 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 BODILY INJURY (Per person) $ p, ANY AUTO RRS56324209 01/01/2025 01/01/2026 R OWNED F SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED. AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS- DE DED RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE PER 77 OTH- STATUTE ER E.L. EACH ACCIDENT _ $ OFFICE R/M EMBER EXCLUDED? ❑ NIA -- (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as additional insured per attached forms ECC3190712, ECC3200712 which do not apply to Professional Liability part, and ECC5480317 CERTIFICATE HOLDER 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 -Public Works Engineering 51 Winburn Way AUTHORIZED REPRESENTATIVE Ashland OR 97520 �✓" ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1 , 7 Coleman Creek Consulting, Inc. Automatic Additional Insured — Owners, Lessees or Contractors THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. In consideration of an additional premium of $Applied this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY CONTRACTORS POLLUTION LIABILITY SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. The person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's vicarious liability arising out of your ongoing operations performed for that insured. ECC-319-0712 © 2018, Freberg Environmental, Inc. Page 1 of 1 Coleman Creek Consulting, Inc. Automatic Waiver of Subrogation Endorsement THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies coverage provided under the following coverage part(s): COMMERCIAL GENERAL LIABILITY CONTRACTORS POLLUTION LIABILITY SCHEDULE Name of Person or Organization: Any person(s) or organization(s) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insured's work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. ECC-320-0712 ©2018, Freberg Environmental, Inc. Page 1 of 1 1V4 Coleman Creek Consulting, Inc. Automatic Primary and Non -Contributory Insurance Endorsement Designated Work Or Project(s) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the Coverage Part(s) indicated below: COMMERCIAL GENERAL LIABILITY CONTRACTORS POLLUTION LIABILITY PROFESSIONAL LIABILITY SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of an additional premium of $Applied and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance. ECC-548-0317 © 2018, Freberg Environmental, Inc. Page 1 of 1