The URL can be used to link to this page

Home My WebLink AboutInsurance Certificate: Beynon Sports Surfaces, Inc.Page 1 of 2 CERTIFICATE LIABILITY I DATE(MMI 09/29/202 Y) 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 NAME: Willis Towers Watson Certificate Center _ __ __ Willis Towers Watson Northeast, Inc. PHONE _ IFAX c/o 26 Century Blvd ,q x0: 1-877-945-7378 INC. No): 1-888-467-2378 Ceicates@willis.com P.O. Box 305191 ADDE-MAIL RESS: rtificates@willis.com TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE ! NAIC# INSURERA: XL Insurance America Inc 24554 INSURED INSURERS Travelers Property Casualty Company of Ame' 25674 Beynon Sports Surfaces, Inc.--------._.�....------....—..------...—..------------ INSURERC: Travelers Indemnity Company of America 25666 19600 SW 129th Ave, Suite A ---..___------.-------------_—.-- ---- �__--- Tualatin, OR 97062 INSURERD: Standard Fire Insurance Company 19070 INSURER E : C0VFRAGFS CERTIFICATF NIIMRER- W38819997 RRVICInN hlillUlnC01 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. IINTp i TYPE OF INSURANCE �ADDLISUBR __ POLICY EPF I POLICY EXP 1 WVD POLICY NUMBER pAM DDIYYYY MM DDlYVYY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE is 1,000,000 51-70 CLAIMS -MADE i OCCUR DAMAGE TO RENTED PREMISES_{Ea occ uren_ce) $ _ 500,000 A MED EXP (Any one person) $ 10,000 Y US00010327LI25A 105/01/2025 05/01/2026IPERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 GENERAL AGGREGATE _ PRO• i POLICY I� JECT L� LOC I PRODUCTS - COMP/OP AGG i C $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY (GCOMBINED tSINGLE LIMIT $ 5,000,000 AUTO x ; ANY A � �I � BODILY INJURY (Per person) � $ B OWNED �I' SCHEDULED AUTOS ONLY AUTOS Y I TC2JCAP-823K312A-TIL-25 105/01/2025 05/01/2026 BODILY INJURY (Per accident) $ �f { HIRED NON -OWNED i I � j _ f PROPERTY DAMAGE $ AUTOS AUTOS ONLY —ONLY I l (Per accident)_ A UMBRELLA LIAB X I OCCUR j EACH OCCURRENCE — Is 5,000,000 �$ 5,000,000 EXCESSLIAB GLAIMS•MADE US00010615LI25A !05/01/2025 05/01/2026i (AGGREGATE DED X L RETENTION $ 10,000 WORKERS COMPENSATION I I X PER 4 OTH- AND EMPLOYERS' LIABILITY y 1 N __L STATUTE $ 1,000,000 C ; ANYPROPRIETOR!PARTNER/EXECUTIVE IE.L. No NIA; EACH ACCIDENT OFFICE RIM EMBER EXCLUDED? UB-8P793534-25-51-K �05/01/2025 05/01/202GI 1,000,000 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ II yes, describe under DESCRIPTION OF OPERATIONS bolo ty _.- E.L. DISEASE • POLICY LIMIT $ 1,000,000 D Workers Compensation & UB-8P760619-25-51-R 105/01/2025 05/01/2026 E.L. Each Accident $1,000,000 Employer's Liability E.L. Disease-Pol Lmtl$1,000,000 Per Statute ! E.L. Disease -Each Emp $1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) WC Policies: Policy # UB-8P793534-25-51-K - covers all other states. Policy If UB-BP760619-25-51-R - covers AZ, MA, WI only. Project Name and Description: Tennis Court Surfacing at Hunter Park and Lithia Park in Ashland, Oregon. Owner Job: APRC ITB, BSS Job#TBD , I�lh=U7.ii1�1RJ�l City of Ashland Ashland Parks & Recreation Commission (APRC) 340 S. Pioneer 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 pax;�;o, a �r,Hy 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD sR ID: 27672256 BATCH: 3942525 6473: 2 ` of 2 AGENCY CUSTOMER ID: LOC #: AC<::)Rf> ADDITIONAL REMARKS SCHEDULE Page 2 Of 2 AGENCY NAMED INSURED Beynon Sports Surfaces, Inc. Willis Towers Watson Northeast, Inc. 19600 SW 129th Ave, Suite A Tualatin, OR 97062 POLICY NUMBER See Page I CARRIER NAIC CODE See Page I See Page I EFFECTIVE DATE: See Page I ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 27672256 13ATCH: 3942525 CERT: W38819997 64 73: 2 o1`2