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HomeMy WebLinkAboutInsurance Certificate: Hannon Enterprises Inc, DBA: Overhead Door Co. of the Rogue Valley �A )R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D D/YYYY) 04/22/2025 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Morning Rigsby NAME: Redwoods Leavitt Insurance Agency a/CNN. Ext: (855)285-5690 a/c,No): (541)479-2669 700 E Main Street,Suite 101 E-MAIL morning-rigsby@leavitt.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Medford OR 97504 INSURERA: Midwest Family Mutual Insurance Company 23574 INSURED INSURER B: SAIF Corporation 36196 Hannon Enterprises Inc,DBA:Overhead Door Co.of the Rogue Valley INSURER C: PO Box 8193 INSURER D INSURER E: Medford OR 97501 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2542217987 REVISION NUMBER: THIS IS TO CERTIFYTHAT 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 MAYBE 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGESOEa occurrDence $ 500,000 MED EXP(Any one person) $ 5,000 A Y Y CPOR0560121972 04/29/2025 04/29/2026 PERSONAL&ADVINJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A OWNED �/ SCHEDULED Y Y CPOR0560121972 04/29/2025 04/29/2026 BODILY INJURY(Per accident) $ AUTOS ONLY /� AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident Uninsured motorist $ 1,000,000 UMBRELLA LIAB X 2,000,000 OCCUR $EACH OCCURRENCE A EXCESS LIAB CLAIMS-MADE CPOR0560121972 04/29/2025 04/29/2026 AGGREGATE $ 2,000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION X1 SPER TATUTE X EORH Increased Limits AND EMPLOYERS'LIABILITY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? N/A Y 631720 02/01/2025 02/01/2026 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Ashland,Oregon its officers,agents and employees are Additional Insured General Liability Ongoing&Completed Operations including Primary Non-contributory&Waiver of Subrogation per endorsement MFMBP036 09-18 attached.; Auto Additional Insured Primary Noncontributory MFMML4 04-0; Auto Waiver Subrogation per MFMML5 04-05;Workers Comp Waiver Subrogation per WC000313 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St 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 BUSINESSOWNERS MFMBP036 09-18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ULTIMATE LIABILITY ADVANTAGE ENDORSEMENT This endorsement modifies insurance provided under the BUSINESSOWNERS COVERAGE FORM and provides the following coverages: Coverage Limits ,Bail Bonds $5,000 Loss of Earnings $1,000 Automatic Liability Coverage—Newly 120 Days—Period of Coverage Acquired or Constructed Property Damage to Property-Borrowed Equipment $5,0100 Blanket Additional Insured—Primary Included if required by Written Contract or &Non Contributory—Ongoing and Written Agreement Completed Operations Damage to Premises Rented to You $3100,000 Contractual Liability—Railroad Included in General Liability Limit Blanket Waiver of Subrogation Included if required by Written Agreement MFMBP0316 09-18 Page 1 of 4 BUSINESSOWNIERS MFMBP036 09-18 The provisions of the Businessowners Coverage the bu Iding that would qualify as covered Form apply except as otherwise provided in this property. endorsement. We will charge you additional premium for the liability from the date you acquire the property The following changes are made to the or beg n construction of that part of the Businessowners Coverage Form: building that would qualify as covered property, Damage to Property—Borrowed Equipment Bail Bonds,Loss of Earning§and Automatic Liability Coverage—Newly Acguired or The following change is made to B. Excluslions— Constructed Pro erty 1.Applicable To Business Liability Coverage k.IDamage To Property—the following is added SECTION 11—LIABILITY—A. Coverages—1. to(4) Business Liability This exclusion does not apply to "property f. Coverage Extension—Supplementary damage"to borrowed equipment while at a Payments—The following is changed: jobsite and while not being used to perform (b) 'Up to$5,000 for cost of bail bonds required operations.The most we will pay for "property because of accidents or traffic law violations damagie"to any one piece of borrowed arising out of the use of any vehicle to which equipment under this coverage is$5,000 per Business Liability Coverage for'bodily injury" occurrence. applies.We do not have to furnish these blonds. And; Blanket Ad'ditioiniail insured—Primary and Non (d)All reasonable expenses incurred by the Contributory—On pin anid Comp!eted insured at our request to assist us in the Operations, investigation or defense of the claim or"suit", including actual loss of earnings up to$1,000 a The following is added to C.Who Is An Insured day because of time off from work. 3.The following are also an insured. A. Insured is amended to include as an insured The following Coverage Extension is added: any pei son or organization who you are (3) For any newly acquired or constructed required to add as an additional insured on this property that is intended for the similar use and policy under a written contract or a written operation as described in the Declarations we agreement, but only with respect to liability for will extend Liability coverage.That coverage will "bodily injury", "property damage" or"personal end when any of the following first occurs: and advertising injury"caused in whole or in (a)This policy expires; or part by: (b) 120 days expire after you acquire the I Your acts or omissions; property or begin construction of that part of 2 The F-cts or omissions of those acting on your behaK,and resulting from; MFMBP036 09-18 Page 2 of 4 BUSINESSOWNERS M F M BP036 09-18 (a)Your ongoing operations performed for the policy providing coverage for the same additional insured; occurrence, claim or suit.This provision does i(b)Your work completed as included in the not appIy to any policy which the additional "products completed operations hazard" insured is a Named Insured on such other policy performed for the additional insured. and where our policy is required by written IEC. However, regarding provision A. above: contract or written agreement to provide 1. We will not extend insurance coverage to any coverage to the additional insured on a primary additional insured or organization: and inon-contributory basis. (a)That is not provided to you in this policy; or (b)That is any broader coverage than you are Damage to Premises Rented To You required to provide to the additional insured person or organization in the written contract The following change is made to D. Liability And or written agreement. Medicall Expenses Limits Of insurance— G.The insurance provided to the additional paragraph 3. Is deleted and replaced with the insured person or organization does not apply following,. to "bodily injury", "property damage", or 1 The most we will pay under Business'Liability "personal and advertising injury" arising out of Coverage for damages because of"property your rendering of,or the failure to render, any damage"to a premises while rented to you or professional architectural,engineering or in the case of fire while rented to you or surveying services including: temporarily occupied by you with permission of 1.The preparing, approving or failing to prepare the owner is$300,000.This limit replaces the or approve maps, shop drawings, opinions, limit shown in the Declarations for Damage to reports,surveys,field orders, change of ordleirs Premises Rented to You. or drawings and specifications; and Z.Supervisory inspection, architectural or Contractual Liability—Railroad engineering activities. D. For the coverage here. The following change is made to F. Liability And 1.The Insurance is primary with respects to our Medical Expenses Definitions—9. "Insured coverage for the additional insured person or contract" is changed to include contractual organization where the written contract or liability—railroads.The definition of"insured written agreement requires this insurance be contract" is replaced with the following: primary and non-contributory. In that event,we 9. "Insured contract" means: will not seek contribution from any other a.A contract for a lease of premises. However, insurance policy available to the additional that portion of the contract for a lease of insured on which the additional insured person premises that indemnifies any person or or organization is a Named Insured. organization for damage by fire to premises 2.This insurance is excess over any other while rented to you or temporarily occupied by insurance,whether primary, excess, contingent you with permission of the owners is not an or any other basis,available to an additional "insured contract"; insured, in which the additional insured on our b.A sidetrack agreement; policy is also,covered as an additional insured c. Any easement or license agreement; by attachment of an endorsement to another MFMBP036 09-18 page 3 of 4 BUSINESSOWNERS MFMBP1036109-18 cl.An obligation, as required by ordinance,to made to IK.Transfer Of Rights of recovery indemnify a municipality, except in connection Against Others To Us—paragraph 2, is deleted with work for a municipality; and replaced with the following: e. An elevator maintenance agreement; 2.Applicable to Businessowners Liability f.That part of any other contract or agreement Coverage: pertaining to your business(including an If the insured has rights to recover all or part of indemnification of a municipality in connection any payment we have made under this policy, with work performed for a municipality) under those rights are transferred to us.The insured which you assume the tort liability of another must do nothing after loss to impair them.At party to pay for"bodily injury" or"property our request,the insured will bring"suit" or damage" to a third person or organization,Tort transfer those rights to us and help us enforce liability means a liability that would be imposed them.This condition does not apply to Medical by law in the absence of any contract or Expenses Coverage, agreement. Paragraph f. does not include that part of any We waive any Right of Recovery we may Ihave contract or agreement: against any additional insured as required in a (1) That indemnified an architect, engineer written agreement because of payments we ,or surveyor for injury or damage arising make for injury or damage arising out of your out of: ongoing operations or your work done under a. Preparing, approving or failing to contract with that person or organization. prepare or approve maps,shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications;or b. Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1)above and supervisory, inspection, architectural or engineering activities, Blanket Wgjyff_q Sou r�cw a�tioo SECTION III—COMMON POLICY CONDITIONS (APPLICABLE TO SECTION I—PROPERTY AND SECTION 11—LIABILITY)The following change is MFMBP036 09-18 Page 4 of 4 CPOR0560121972 MFM ML4 04-05 Amendatory Endorsement#4 MIDWEST FAMILY MUTUAL INSURANCE COMPANY INSURED: HANNON ENTERPRISES INC DBA OVERHEAD DOOR CO. OF THE ROUGE VALLEY POLICY NUMBER:CPOR05601219V2 LINE OF BUSINESS: COMMERCIAL AUTO - STANDARD BLANKET ADDITIONAL INSURED BY CONTRACT THE ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: BUSINESS AUTO COVERAGE FORM THIS ENDORSEMENT CHANGES THE POLICY EFFECTIVE ON THE INCEPTION DATE OF THE POLICY UNLESS ANOTHER DATE IS INDICATED. WITH RESPECT TO COVERAGE PROVIDED BY THIS ENDORSEMENT, THE PROVISIONS OF THE COVERAGE FORM APPLY UNLESS MODIFIED BY THE ENDORSEMENT. SECTION II LIABILITY COVERAGE, A COVERAGE 1. WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN INSURED ANY PERSON OR ORGANIZATION WITH WHICH YOU HAVE AGREED IN A VALID WRITTEN CONTRACT TO PROVIDE INSURANCE AS AFFORDED BY THIS POLICY. THIS PROVISION IS LIMITED TO THE SCOPE OF THE VALID WRITTEN CONTRACT. THIS PROVISION DOES NOT APPLY UNLESS THE VALID WRITTEN CONTRACT HAS BEEN EXECUTED PRIOR TO THE BODILY INJURY OR PROPERTY DAMAGE. THIS COVERAGE IS ON A PRIMARY AND NON CONTRIBUTORY BASIS. Date 312712023 MIDWEST FAMILY MUTUAL MFMCA007 08-2020 BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the Business Auto Coverage Form. Please read it carefully. Section IV,A.5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any Right of Recovery we may have against any additional Insured as required in a written agreement because of payments we make for injury or damage arising out of your ongoing operations or your work done under contract with that person or organization. MFMCA007 08-2020 Page 1 of 1 IL 02 79 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraph 2. of the Cancellation Common Policy (7) Loss or decrease in reinsurance cover- Condition is replaced by the following: ing the risk. 2. If this policy has been in effect for: c. 60 days or more or is a renewal policy, we a. Fewer than 60 days and is not a renewal may cancel for any other reason approved policy, we may cancel for any reason. by the commissioner by rule, but only with respect to insurance provided under the fol- b. 60 days or more or is a renewal policy, we lowing: may cancel only for one or more of the fol- lowing reasons: (1) A package policy that includes commer- cial property and commercial liability in- (1) Nonpayment of premium; surance; (2) Fraud or material misrepresentation (2) Commercial Automobile Coverage Part; made by you or with your knowledge in obtaining the policy, continuing the pol- (3) Commercial General Liability Coverage icy or in presenting a claim under the Part; policy; (4) Commercial Property Coverage Part — (3) Substantial increase in the risk of loss Legal Liability Coverage Form; after insurance coverage has been is- (5) Commercial Property Coverage Part — sued or renewed, including but not lim- Mortgageholders Errors And Omissions ited to an increase in exposure due to Coverage Form; rules, legislation or court decision; (6) Employment-related Practices Liability (4) Failure to comply with reasonable loss Coverage Part; control recommendations; (7) Farm Coverage Part — Farm Liability (5) Substantial breach of contractual duties, Coverage Form; conditions or warranties; (8) Liquor Liability Coverage Part; (6) Determination by the commissioner that (9) Products/Completed Operations Liability the continuation of a line of insurance or Coverage Part; or class of business to which the policy be- longs will jeopardize our solvency or will (10) Medical Professional Liability Coverage place us in violation of the insurance Part. laws of Oregon or any other state; or IL 02 79 09 08 © ISO Properties, Inc., 2007 Page 1 of 2 0 B. Paragraph 3. of the Cancellation Common Policy However, if this policy is issued for a term of Condition is amended by the addition of the follow- more than one year and for additional consid- ing: eration the premium is guaranteed, we may not 3. We will mail or deliver to the first Named In- refuse to renew the policy at its anniversary sured written notice of cancellation, stating the date. reason for cancellation. Nonrenewal will not be effective until at least C. The followings is added to the Cancellation Com- 45 days after the first Named Insured receives rmon;Policy Condition. our notice. 7. Number Of Oars'Notice Of Cancellation: 2. Mailing Of Notices a. With respect to insurance provided under a. If notice of cancellation or nonrenewal is 2.c.(1) through (10) above, cancellation will mailed, a post office certificate of mailing not be effective until at least 10 working will be conclusive proof that the first Named days after the first Named Insured receives Insured received the notice on the third cal- our notice. endar day after the date of the certificate of b. With respect to insurance other than that mailing. provided under 2.c.(1) through (10) above, b. The following provision applies with respect cancellation will not be effective until at to coverage provided under the Farm Cov- least: erage Part: (1) "lit days after the first Famed Insured) If the first Named Insured has affirmatively receives our notice, if we cancel for consented to our use of an electronic re- nonpayment of premium; or cord to deliver notice of cancellation or non- renewal and has not withdrawn such con- (2) 30 days after, the first Named Insured sent, then the electronic record delivering receives our notice) if e cancel for any notice of cancellation or nonrenewal satis- other reason. fies the requirement that the notice of can- D. Paragraph 6. of the Cancellation Common Policy cellation or nonrenewal be provided, or Condition does not apply. made available, to the first Named Insured E. The following are added and supersede any provi- in writing if we send the first Named Insured sion to the contrary: the electronic record with a request for a re- turn receipt and we receive the return re- f. Nonrenewal ceipt. If we do not receive the return receipt, We may elect not to renew this policy by mail- we may cancel or nonrenew the policy only ing or delivering to the first Named Insured, at after providing or delivering the notice of the last mailing address known to us, written cancellation or nonrenewal to the first notice of nonrenewal before the: Named Insured in writing, subject to Para- a. Expiration date of the policy; or graph 2.a. above. b. Anniversary date of the policy if the policy is written for a term of more than one year or without a fixed expiration date. Page 2 of 2 © ISO Properties, Inc., 2007 IL 02 79 09 08 0 www.saif.com ■ S Aoft Wfek. . cif r Oregon. Carrier no: 20001 Endorsement no: WC360601E (Ed. 210A) SAIF policy: 631720 Hannon Enterprises Inc Oregon Cancellation Endorsement This endorsement applies only to the insurance provided by the policy because Oregon is shown in Item 3.A. of the Information Page. The Cancellation Condition of the policy is replaced by this Condition: D. Cancellation 1. You may cancel this policy. You must mail or deliver advance written notice to us, stating when the cancellation is to take effect. If you provide for other insurance or self-insurance, your cancellation of coverage will take effect upon the effective date of that insurance. 2. We may cancel this policy. We will mail to you advance written notice stating when the cancellation is to take effect. a. If we cancel based on our decision not to offer insurance to all employers within your premium category, we will mail the notice of cancellation at least 90 days before the cancellation is to take effect. b. If we cancel for other reasons, we will mail the notice of cancellation at least 45 days before the cancellation is to take effect. c. If we cancel for nonpayment, we will mail notice of cancellation at least 10 days before the cancellation is to take effect. 3. Mailing notice to you at your last known mailing address will be sufficient to prove notice. 4. The policy period will end at 12:01 AM on the day stated in the cancellation notice. 5. When coverage is placed with another carrier as of the policy expiration date, a rejected renewal policy shall be withdrawn without charge, provided notice of nonrenewal is mailed and postmarked on or before the expiration date and is received from the insured by the insurer no later than 10 calendar days after said expiration date. Effective date: February 01, 2025 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned December 28, 2024 at Salem, Oregon WC360601E Chip Terhune (Ed. 210A) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E210A www.saif.com ■ S Aoft Wfek. . cif r Oregon. Carrier no: 20001 Endorsement no: WC000313 (Ed. 430B) SAIF policy: 631720 Hannon Enterprises Inc Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: All Operations Contractor name: Persons and/or organizations who, with the insured-employer are parties to a construction agreement as defined in ORS 30.140. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective date: February 01, 2025 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned December 28, 2024 at Salem, Oregon WC000313 Chip Terhune (Ed. 430B) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E430B