HomeMy WebLinkAboutInsurance Certificate: Curtius Plumbing and Mechanical, Inc � l � 7TE{MM/DDlYYYY}
' il`. .R�' CERTIFICATE OF LIABILITY INSURANCE 04129/2026
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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY E --
HOME OFFICE:P.O.BOX 328 (ArC,No,Ext):888-3334949 taC,No):507-446-4664
OWATONNA,MN 55060 ADDRESS:CLIEN_TCONTACTCENTER@FEDINS.COM
INSURERS AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024
INSURED INSURER B:
CURTIUS PLUMBING AND MECHANICAL,INC INSURERC:
1896 DELTA WATERS RD
MEDFORD,OR 97504-4705 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:216 REVISION NUMBER:0
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.
IN SR TYPE OF INSURANCE jADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MMtOD7YYYY MMtDD1YYYY
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTEDPREMISE5 $100,000
_ (Ea occurrence)
MED EXP(Any one person) EXCLUDED
A Y I Y 9353730 05/09/2026 05/09/2027 PERSONAL&ADV INJURY $1,000,000
GENT.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X POLICY DE LOC PRODUCTS&COMPfOP ACC $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
X ANYAUTO BODILY INJURY(Per Person)
A OWNED AUTOS ONLY]SCHEDULED
I Y N 9353730 05/09/2026 05/09/2027 BODILY INJURY(Per Accident)
HIRED AUTOS ONLY NON-04YNED it - PROPERTY DAMAGE
AUTOS ONLY (Per Accident)
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000
A EXCESS LIAR CLAIMS-MADE Y N 9353731 05/09/2026 05/0912027 AGGREGATE $5,000,000
DED RETENTION
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY yfN PER STATUTE ETHER
ANY PROPRIETOR/PARTNER!EXECUTIVE
E.L EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? .......
(Mandatory in NH) N/A
E.L DISEASE EA EMPLOYEE
'If yes,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT
I
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
SEE ATTACHED PAGE
CERTIFICATE HOLDER CANCELLATION'
CITY OF ASHLAND 2160
20 E MAIN ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
ASHLAND,OR 97520-1814 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
OO 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
fLOC#:
ADDITIONAL REMARKS SCHEDULEPage 1 Of 1
AGENCY NAMEDINSURED
FEDERATED MUTUAL INSURANCE COMPANY CURT IUS PLUMBING AND MECHANICAL,INC
1896 DELTA WATERS RD
POLICY NUMBER MEDFORD,OR 97504-4705
SEE CERTIFICATE##216.0
CARRIER NAIL CODE EFFECTIVE DATE'SEE CERTIFICATE#216.0
SEE CERTIFICATE##216.0
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
RE: CITY OF ASHLAND 1175 E MAIN STREET, ASHLAND OR 97520 8 1295 OAK STREET, ASHLAND OR 97520.
SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY., ADDITIONAL INSURED ALSO INCLUDES: THE CITY OF ASHLAND, OREGON,
ITS OFFICERS, AGENTS AND EMPLOYEES.
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO THE CONDITIONS OF THE ADDITIONAL
INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) ENDORSEMENT.
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT
ENDORSEMENT FOR BUSINESS AUTO LIABILITY.
INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO
THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION.
GENERAL LIABILITY CONTAINS A WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
- AUTOMATIC ENDORSEMENT
FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, _ DAYS NOTICE WILL BE PROVIDED TO THE CERTIFICATE HOLDER IN THE
EVENT THAT THE ISSUING COMPANY CANCELS THE POLICY BEFORE THE EXPIRATION DATE OF THE POLICY.
ACORD 101 (2008/01) ID 2008 ACORD CORPORATION.All rights reserved.
The ACORD name and logo are registered marks Of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
A. WHO IS AN INSURED for"bodily injury" and "property damage" liability is amended to include:
Any person or organization other than a joint venture, for which you have agreed by written contract to
procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered
"auto" with your permission. However, this additional insurance does not apply to:
(1) The owner or anyone else from whom you hire or borrow a covered "auto'. This exception does
not apply if the covered"auto` is a "trailer" connected to a covered "auto"you own.
(2) Your "employee if the covered "auto' is owned by that "employee" or a member of his or her
household.
(3) Someone using a covered "auto" while he or she is working in a business of selling, servicing,
repairing, parking or storing "autos" unless that business is yours.
(4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a
limited liability company), or a lessee or borrower or any of their "employees", while moving
property to or from a covered "auto'.
(5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a
covered "auto"owned by him or her or a member of his or her household.
B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms,
conditions, and exclusions of the Coverage Part to which this endorsement is attached.
In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written
agreement to add any insured, or to procure insurance.
C. The limits of insurance applicable to such insurance shall be ,the lesser of the limits required by the
agreement between the parties, or the limits provided by this policy.
D. Additional exclusions. The insurance afforded to any person or organization as an insured under this
endorsement does not apply:
1. To 'loss" which occurs prior to the date of your contract with such person or organization;
2. To 'loss" arising out of the sole negligence of any person or organization that would not be an insured
except for this endorsement.
3. To `loss" for any leased or rented "auto' when the lessor or, his or her agent takes possession of the
leased or rented "auto' or the policy period ends, whichever occurs first.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
CA-F-127 (03-03) Policy Number: 9353730 Transaction Effective Date: 05/09/2026
COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance (2) You have agreed in writing in a contract
Condition and supersedes any provision to the or agreement that this insurance would be
contrary: primary and would not seek contribution
Primary And Noncontributory Insurance from any other insurance available to the
This insurance is primary to and will not seek additional insured.
contribution from any other insurance available to
an additional insured under your policy provided
that:
(1) The additional insured is a Named Insured
under such other insurance; and
0 Insurance Services Office, Inc., 2018 Page 1 of 1
CG 20 01 12 19 Policy Number: 9353730 Transaction Effective Date: 05/09/2026
COMMERCIAL GENERAL LIABILITY
CG24531219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINSTOTHERS TO US (WAIVER OF SUBROGATION)AUTOMATIC
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of Section
IV- Conditions:
We waive any right of recovery against any person or
organization, because of any payment we make under
this Coverage Part, to whom the insured has waived
its right of recovery in a written contract or
agreement. Such waiver by us applies only to the
extent that the insured has waived its right of recovery
against such person or organization prior to loss.
0 Insurance Services Office, Inc., 2018 Page 1 of 1
CG 24 53 12 19 Policy Number: 9353730 Transaction Effective Date: 05/09/2026
�
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [[CAREFULLY.
ADDITIONAL INSURED _ OWNERS, LESSEES OR
CONTRACTORS (FORM 13)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name ef Person orOrganization:
City ofAshland
2OE Main St
Ashland, OR87S2O-1814
(|f no entry appears above, information required to complete this endorsement will be shown in the Declarations
am applicable tuthis endorsement.)
WHO IS AN INSURED (Section ||) im amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of"your work"for that insured by or for you.
Job or% Project:
See |LF40O0031
Insured:
Curbuo Plumbing and Mechanical, Inc
1096De|ta Waters Rd
Medford, OR07SO4-4705
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CG-F-64 (06-10) Policy Number: O353730 Transaction Effective Date: 05/0Q/2O26
(CG2U1O 11-85)
IL-F-40-00031 Extension Endorsement
Any coverage provided by this endorsement applies only to City of Ashland
1175 E Main Street , Ashland OR 97520 & 1295 Oak Street , Ashland OR 97520 .
Subject to the terms and conditions of the policy, additional insured also
includes : the City of Ashland, Oregon, its officers, agents and employees .
IL-F-40-00031 (06-10) Policy Number: 9353730 Transaction Effective Date: 05/09/2026
358-691-4 216
BWDHBS B0000-06-0051
XWXW0021 XXXXXXX5
CITY OF ASLAND
20 E Main St
Ashland, OR 7520-181
l �. DATE(MMtOD/YYVY)
�''�`'�mi CERTIFICATE OF LIABILITY INSURANCE 04/2 9120 26
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 NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PH Tt� FAx
HOME OFFICE:P.O.BOX 328 (AtC,No,Ext}:888 333 4949 SA C,No 507446-4664
OWATONNA,MN 55060 AIL
ADDRess:CLIENTCONTACTCENTER@FEDINS.COM _ _
INSURERS AFFORDING COVERAGE NAIC#1
INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024
INSURED INSURER 6: _
CURTIUS PLUMBING AND MECHANICAL,INC INSURER C:
1896 DELTA WATERS RD
MEDFORD,OR 97504-4705 INSURER D: _
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:24 REVISION NUMBER:0
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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR 4WD MMIDDtYYYY MMIDDIYVYY
X COMMERCIAL GENERALUABILITY EACH OCCURRENCE $1,000,000
OCCUR DAMAGE
CLAIMS-MADE TOrence RENTED) PREMISES $100 O00
(Ea accur
MED EXP(Any one person) EXCLUDED
A N N 9353730 05/W/2026 05/09/2027 PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X POLICY PRO- LOC PRODUCTS&COMP(OP ACC $2,000,000
OTHER' _�1E
GO AUTOMOBILE LIABILITY BcideO)SINGLE LIMIT $1,000,000
JANYAUTO BODILY INJURY(Per Person)
AOWNED AUTOS ONLY SCHEDULED N N 9353730 05/09/2026 05109/2027 BODILY INJURY(Per Accident)
AUTOS — —
FIIRED AUTOS ONLY NON-OWNED PROPERTY
Pa PER Y DAMAGE
AUTOS ONLY
LI
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $S,000,QOO
A EXCESS HAD CLAIMS-MADE N N 9353731 05/09/2026 05/09/2027 AGGREGATE $5,000,000
DED RETEN I ION
WORKERS COMPENSATION PER STATUTE THER
AND EMPLOYERS'LIABILITY YIN
IANY PROPRIETORIPARTNERt EXECUTIVE E.L EACH ACCIDENT
IOFFICERtMEMBER EXCLUDED?
I(Mantlatary in NH) N/A E.L DISEASE EA EMPLOYEE
I1 yes,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space is required)
CERTIFICATE HOLDER CANCELLATION
CITY OF ASHLAND 24 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
20 E MAIN ST
ASHLAND,OR 97520-1814 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WII L BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
} }t fI
d 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
358-691-4 24
#BWNDFI S B0000-06-0043
XWXWO021 XXXXXXX5#
CITY OF ASHLA D
20 E Main St
Ashland, OR 97520-1814
Additional Insured Copy
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
' ADDITIONAL INSURED - ���' ��������� R
� OWNERS,
CONTRACTORS (FORM 13)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name of Person mr Organization:
City of Ashland
20 E Main St
Ashland, OR87S20-1814
(|f no entry appears above, information required to complete this endorsement will be shown in the Declarations
us applicable to this endoraement.)
WHO IS AN INSURED (Section ||) is amended to include as an insured the person or organization shown in the
Schedu|e, but only with respect to liability arising out of"your work"for that insured by mr for you.
�
� Job mp Project:
Seo |L-F-40-00031
|mmwrad:
Cudiva Plumbing and Mechanical, Inc
1808 Delta Waters Rd
Medford, OR875O4-47D5
\
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CG-F-84 (06-10) Policy Number: 8353730 Transaction Effective Dude: 0S/OA/2O2G
(CG2O1O 11-85)
Additional Insured Copy
IL-F-40-00031 Extension Endorsement
Any coverage provided by this endorsement applies only to City of Ashland
1175 E Main Street , Ashland OR 97520 & 1295 Oak Street , Ashland OR 97520 .
Subject to the terms and conditions of the policy, additional insured also
includes : the City of Ashland, Oregon , its officers , agents and employees .
IL-F-40-00031 (06-10) Policy Number: 9353730 Transaction Effective Date: 05/09/2026