HomeMy WebLinkAboutInsurance Certificate: RH2 Engineering, Inc. DATE(MM/DD/YYYY)
A�" CERTIFICATE OF LIABILITY INSURANCE
11/07/2025
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 Jona Bolin
NAME:
Sammamish Insurance,Inc. a/cNr o Ext: (425)898-8780 (FAX
,No): (425)836-2865
704228thAve NE,PM 373 E-MAIL JonaBolin@msn.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Sammamish WA 98074 INSURERA: Ohio Security Insurance Company 24082
INSURED INSURER B: The Ohio Casualty Insurance Company 24074
RH2 Engineering Inc INSURER C: Rated by Multiple Companies 00914
22722 29th Dr SE Ste 210 INSURER D: Continental Casualty Company 20443
INSURER E
Bothell WA 98021 INSURER F
COVERAGES CERTIFICATE NUMBER: CL2592904398 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 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 $ 2,000,000
CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 2,000,000
MED EXP(Any one person) $ 15,000
A Y BZS57962270 05/29/2025 05/29/2026 PERSONAL&ADV INJURY $ 2,000,000
GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000
X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4'000'000
JECT
OTHER: Stopgap-WA $ 2,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
ANYAUTO BODILY INJURY(Per person) $
A X OWNED SCHEDULED Y BAS57962270 05/29/2025 05/29/2026 BODILY INJURY(Pe r accide nt) $
/� AUTOS ONLY AUTOS
X HIRED �/ NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY /� AUTOS ONLY Per accident
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
B EXCESS LAB CLAIMS-MADE Y US057962270 05/29/2025 05/29/2026 AGGREGATE $ 2,000,000
DED I X1 RETENTION $ 10,000 $
WORKERS COMPENSATION ER/� STATUTE EORH
AND EMPLOYERS'LIABI LI TY YIN 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
C OFFICER/MEMBER EXCLUDED? NIA 52WECDL6432 10/14/2025 10/14/2026
(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 $
Professional Liability Per Claim $3,000,000
D Claims Made AEH004312321 05/29/2025 05/29/2026 Aggregate $5,000,000
Deductible $ 200,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
The City of Ashland,Oregon and its officials,officers and employees are named as additional insured automatically where required by contract as respects
General Liability,Automobile Liability and Umbrella liability Coverage is Primary and Non-Contributory.
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 East Main Street
AUTHORIZED REPRESENTATIVE
Ashland OR 97520 � ! 'x
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