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HomeMy WebLinkAboutInsurance Certificate: DOWL, LLC (2) 74/29/2025 (MM/DDIYYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 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: IMA, Inc. PHONE FAX 10400 NE 4th Street, Suite 900 AIC No Ext: 316-267-9221 A/C,No):316-266-6254 Bellevue WA 98004 ADDRIESS, INSURER(S)AFFORDING COVERAGE NAIC# License#:PC-1210733 INSURER A:The Charter Oak Fire Insurance Company 25615 INSURED DOWLLLC-01 INSURER B:The Travelers Indemnity Company 25658 DOWL, LLC 920 Country Club Road, Suite 100B INSURERC:Travelers Property Casualty Company of America 25674 Eugene, OR 97401 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1462656362 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 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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LTR MM/DDIYYYYI iMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y P6305W32478000F25 5/1/2025 5/1/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY� PE� LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y 8105W3264352543G 5/1/2025 5/1/2026 COMBINEDSINGLELIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ C UMBRELLALIAB X OCCUR Y Y CUP5W3305772543 5/1/2025 5/1/2026 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$1 n nnn $ A WORKERS COMPENSATION UB5W3306692543G 5/1/2025 5/1/2026 X PER X OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project No.2752.80159.00, North Mountain Avenue Overlay-1-5 to E.Main. City of Ashland,Oregon, its elected officials,officers and employees are included as Additional Insured on the General Liability,Auto Liability and Excess Liability Policies, if required by written contract or agreement,subject to the policy terms and conditions. This Insurance is Primary&Non-Contributory on the General Liability,Auto Liability and Excess Liability Policies, if required by written contract or agreement, subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of the Certificate Holder and all other parties required by the contract on the General Liability,Auto Liability and Excess Liability Policies, if required by written contract or agreement,subject to the policy terms and conditions. See Attached... 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, Oregon 20 East Main Street 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 AGENCY CUSTOMER ID: DOWLLLC-01 LOC#: ACOOR" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED IMA, Inc. DOWL, LLC 920 Country Club Road, Suite 10oB POLICY NUMBER Eugene,OR 97401 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE General Liability,Auto Liability,Excess Liability and Workers Compensation Coverage(s)include 30 day notice of cancellation,subject to the policy terms and conditions. Excess Liability policy is in excess of the General Liability,Automobile Liability and Employers Liability Policies,subject to the policy terms and conditions. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD