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HomeMy WebLinkAboutInsurance Certificate: Timberline Logging Enterprises, LLC Client#: 2035102 TIMBEHEL DATE(MM/DD/YYYY) ACORDT1,1 CERTIFICATE OF LIABILITY INSURANCE 1 1/02/2026 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 CONTACT Kassi Johnson NAME: USI Insurance Services NW CL PHONE 206 441-6300 FAX 610-362-8530 601 Union Street, Suite 1000 AMA Lo,EXt: (A/c,No): ADDRESS: kassi.johnson@usi.com Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Burlington Insurance Company 23620 INSURED INSURER B:National Union Fire Ins Co of Pitts,PA 19445 Timberline Logging Enterprises, LLC INSURER C:Starr Indemnity and Liability Company 38318 1926 Industrial Dr INSURER D:New Hampshire Insurance Company 23841 Sandpoint, ID 83864 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. ADDLSUBR LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY X 403BG0742703 05/15/2025 05115/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE L*OCCUR PREMISESOEa occu ante $100,000 X BI/PD Ded: 5,000 MED EXP(Any one person) $5,000 PERSONAL$ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY JECTPRO- LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY 01 CA06614528410 01/24/2025 01/24/202 Ea acccioeD SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ XDed:$1,000 X Comp/Coll. $ B UMBRELLA LIAB X OCCUR 29UD0199184014 01/24/2025 01/24/2026 EACH OCCURRENCE $5000000 X EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION X 1001243082 01/01/2026 04/01/2026 X IPER STATUTE EERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (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/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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE �� ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S52432895/M52394414 TBPZP