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HomeMy WebLinkAboutInsurance Certificate: Dietrich Construction, LLC ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 07/13/2026 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 CONTACT Amber Riley NAME: Elliott Powell Baden and Baker Inc. AIC No Ext: (503)227-1771 alc No): (503)274-7644 An ISU Network Member E-MAIL ADDRESS: a(ley@epbb.com 1521 SW Salmon Street INSURERS)AFFORDING COVERAGE NAIC# Portland OR 97205-1783 INSURERA: Admiral Insurance Company 24856 INSURED INSURERB: Acuity Insurance 14184 Dietrich Construction,LLC INSURER C: Crum 8,Forster Specialty Ins Co 44520 601 Jackpine Dr,Zip Code 97526 INSURER D: SAIF PO Box 1959 INSURER E Grants Pass OR 97528 INSURER F: COVERAGES CERTIFICATE NUMBER. 26-27 GL-XS COI 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.*LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.LIMITS SHOWN ARE INCLUSIVE OF AMOUNTS REQUESTED BY THE CERTIFICATE HOLDER AND MAY NOT REFLECT POLICY LIMITAMOUNTS IN EXCESS OF THOSE REQUESTED. *Not Applicable in WY INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR AMA T RENTED 50,000 PREMISES Ea occurrence) $ MED EXP(Any one person) $ 5,000 A Y Y CA000058163-01 07/20/2026 07/20/2027 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLJES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO ❑LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: JECT $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y ZM9196 05/04/2026 0510412027 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Medical payments $ 5,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAB CLAIMS-MADE GX000009408-01 07/20/2026 07/20/2027 AGGREGATE $ ^00 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION � X PER OTH- --�—�--- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 500,000 D (Mandatory EXCLUDED? ❑ N/A 100080633 11/01/2025 11/01/2026 E.L.EACHACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Contractors Pollution Liab Each Per claim 1,000,000 A Occurence CA000058163-01 07/2012026 07/20/2027 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:The East and West Forks project-Bridge replacement project No.2018-1 oA Please see attached forms EN 0111 02.11,EN 0118 02.11.EN 0320 02.11,CA 7214 10.18 and CA 7247 10.16 for confirmation of additional insured status for the City of Ashland,and its agents,officers,and employees,the Ashland City Council and RH2 Engineering. 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 Street AUTHORIZED REPRESENTATIVE ter Ashland OR 97520 04y�+j�+�^"' XI1111Y ACORD 25(2025/12) ©1988-2025 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD