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Home My WebLink AboutDay Wireless Systems ACOBQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) 07/03/2007 PRODUCER (503)241-9221 FAX (503)221-0540 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Durham and Bates Agencies Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 SW Washington HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 250 Portland, OR 97205-3554 INSURERS AFFORDING COVERAGE NAIC# INSURED Day Management Corporation INSURER A: One Beacon America Ins Co DBA: Day Wireless Systems INSURER B: Navigators Insurance Company 4700 SE'International Way INSURER c: Milwaukie, OR 97222 INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AQO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PRi!fJ' EXPIRATION LIMITS GENERAl LIABILITY 711009918-0000 07/01/2007 07/01/2008 EACH OCCURRENCE S 1,000,001 "X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 1,000,001 I CLAIMS MADE m OCCUR MED EXP (Anyone person) S 10,001 II X $lMM Umbrella PERSON!\L & ADV INJURY S 1,000,001 ... I GENERAL AGGREGATE S 2,000,001 GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS.COM~OPAGG S 2,000,001 n POLICY n ~r8i fXllOC AUTOMOBILE LIABILITY 711009918-0000 07/01/2007 07/01/2008 COMBINED SINGLE liMIT I-- S X ANY AUTO (Ea accidenl) 1,000,001 - ALL OWNED AUTOS BODilY INJURY - $ SCHEDULED AUTOS (Per person) A - HIRED AUTOS BODilY INJURY - $ NON.OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY.. lOA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY SF07EXCI61165NV 07/01/2007 07/01/2008 EACH OCCURRENCE S 8,OOO,Ooe m OCCUR o CLAIMS MADE AGGREGATE $ 8,000,001 B $ R DEDUCTIBLE S RETENTION S $ WORKERS COMPENSATION AND 711009918-0000 07/01/2007 07/01/2008 I T~~~T :lll~~ I IOJ~" EMPLOYERS' LIABILITY WASHINGTON STOP GAP E.L EACH ACCIDENT $ 500 , ooe A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXClL'DED? EMPLOYERS LiABILITY E.L DISEASE.. EA EMPLOYEE $ 500,OOe If res, describe under 500,OOe S ECtAL PROVISIONS below E.l. DISEASE.. POLICY liMIT $ OTHER 711009918-0000 07/01/2007 07/01/2008 Comprehensive & Collision A L.laragekeepers $250,000 Limit $500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS HE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE NAMED AS ADDITONAL NSUREDS ON THE GENERAL LIABILITY INSURANCE PER FORM VCG205 02 05 ATTACHED, BUT ONLY WITH RESPECT TO ONTRACTORS SERVICES TO BE PROVIDE UNDER THIS CONTRACT, SUBJECT TO POLICY TERMS, CONDITIONS AND ~XCLUSIONS * EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM N ". ," \ \ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND, OR 97520 l.. ,,-'I.,.. \ u 2007 \ \ i " , ! j:. 'J .;1 :jl\ ,--j I EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30'~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY _...___.-........w.... OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ Joanna Brown MJK ACORD 25 (2001/08) L___..... -......- @ACORD CORPORATION 1981 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. @VANTAGE FOR GENERAL LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL UABILIlY COVERAGE FORM The following schedule lists the coverage extensions provided by this endorsement. Refer to the individual provi- sions to determine the extent of your coverage. SCHEDULE OF COVERAGE EXTENSIONS 1. Additional Insured - Broad Form Vendors 8. Broadened Property Damage Rented Premises 2. Additional Insured - by Contract, Agreement or 9. Coverage Territory - Worldwide Permit relating to: 10. Duties in Event of Occurrence, Claim or Suit o Work. performed by you 11. Expected or Intended Injury (PO) o Premises you own, rent,lease or occupy 12. Incidental Medical Malpractice o Equipment you lease 13. Medical Payments 3. Aggregate Limit Per Location 14. Mobile Equipment Redefined 4. Blanket Waiver of Subrogation 15. Newly Acquired or Formed Organizations 5. Bodily Injury Redefined- Mental Anguish 16. Non-Owned Aircraft 6. Broadened Named Insured 17. Non-Owned Watercraft 7. Broadened Property Damage 18. Personal and Advertising Injury o Borrowed Equipment 19. Product Recall Expense o Customers' Goods 20. Supplementary Payments Increased Umits o Use of Elevators 1. ADOmONAL fNSURED - BROAD FORM VENDORS Section U - Who Is An Insured is amended to include as an additional insured any person(s) or organlzation(s) (r&ferred to below as vendor) with whom you agreed in a written contract or agreement to provide Insurance, but only with respect to "bodily injury" or .property damage" arising oul of "your products" which are distributed or sold In the regular course of the vendor's business, subject to the following additional exclusions: a. This provision 1. does not apply to: (1) "Bodily Injury" or "property damage" for which the vendor Is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to lIabiflly for damages that the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change In the product made intentionally by the vendor; (4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from the manufacturer, and then repacl<aged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (7) Products which. after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingrMient of any other thing or substance by or for the vendor; or (8) .Bodily inJury" or "propelt)' damage. arising out of the sole negligence .of the vendor for its own acts or omissions or those of its employees or anyone else acting on Its behalf. However, this exclusion does not apply to: (a) The exceptions contained in Subparagraphs 4. or 6.; or (b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally un- dertakes to make in the usual course of business, in connection with the distribution or sale of the pr0d- ucts. YCO 205 02 0& InoIldes copyr1gtted maler1a1 d II'IlUance SeNices Offbt. Inc. eop.,.ijt 2004, 1II11111111l111ll1l1l1""I/IJIIIIIII! "I/'WII" @@@OO@O@OO@O@@@@@@@@@ Page 1 d7 , (9) Any person or organization if the "products-completed operations hazard" is excluded either by the pro- visions of the Coverage Form or by endorsement. b. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 2. ADDITIONAL INSURED - CONTRACT, AGREEMENT OR PERMIT a. Section". Who Is An Insured is amended to include as an additional insured any person(s) or organiza- tion(s) with whom you agreed in a written contract, written agreement or permit to provide insurance such as is afforded under this Coverage Part, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part. by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of "your work" for the additional insured(s) at the location desig nated in the contract, agreement or permit; or 2, In the maintenance, operation or use of equipment leased to you by such person(s) or organizatlon(s), or 3. In connection with premises you own, rent, lease or occupy. This insurance applies on a primary or primary and non-contributory basis if that is required in writing by the contract, agreement or permit. b. The insurance provided to the additional insured herein is limited. This insurance does not apply: 1. Unless (a) the written contract, agreement or permit is currently in effect or becomes effective during the term of this policy; and (b) the contract or agreement was executed or permit issued prior to the "bodily injury-, "property dam- age", or "personal and advertising injury"; 2. To any person or organization included as an insured under the Additiona/lnsured - Broad Form Ven- dors provision of this endorsement: 3. To any person or organization included as an insured by an endorsement Issued by us and made part of this Coverage Part; 4. To any person or organization if the "bodily injury", .property damage", or "personal and advertising in- jury" arises out of the rendering of or failure to render any professional architectural, engineering or surveying services by or for you including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. 5. To any: (a) Lessor of equipment after the equipment lease expires; or (b) Owners or other interests from whom land has been leased; or (c) Managers or lessors of premises If: (1) The "occurrence" takes place after you cease to be a tenant in that premises; or (2) The "bodily injury", "property damage", "personal and advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the man- ager or lessor. 6. To "bodily injury, or .property damage" occurring after: (a) All work on the project (other than service, maintenance or repairs) to be performed by or on be- half of the additional insured at the site of the covered operations has been completed; or (b) That portion of "your work" out of Which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in per- forming operations for a principal as part 01 the same project. c. Limits of Insurance applicable to the additional insured are those specified in the contract, agreement or permit or in the Declarations of this policy, whichever is less, and fix the most we will pay regardless of the number of: 1. Insureds; Page 2 017 Includes ~ material oIlnslnnce Services OIrICe. Inc. ~ 2004. 1/111 Il/I!III I! III I!! ! f1!1!1 fI fit I/!! r! "!I I! !I !I! VCG 205 02 05 2. Claims made or "suits" brought: or 3. Persons or organizations making claims or bringing "suits". These limits of Insurance are inclusive of and not in addition to the limits of Insurance shown in the Decla- rations. 3. AGGREGATE LIMIT PER LOCATION a. Under Section IR - Limits of Insurance, the General Aggregate Limit applies separately to each of your "locations" owned by or rented or leased to you. b. Under Section V - Definitions, the following definition is added: "Location" means premises invoMng the same or connecting lots, or premises whose connection Is in- terrupted only by a street, roadway, waterway or right-of-way of a raDroad. 4. BLANKET WAIVER OF SUBROGATION Section IV - Transfer of Rights of Recovery Against Others to Us Condition is amended to add the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations done under a written contract or agreement with that person or organization and included in "your work" or the "products-completed operations hazard". This waiver applies only to persons or organizations with whom you have a written contract, executed prior to the "bodily injury" or "property damage". that requires you to waive your rights of recovery. 5. BODILY INJURY REDEANED - MENTAL ANGUISH Under Section V the definition of "bodily injury" is replaced by the following: "Bodily Injury" means bodily injury, sickness, or disease sustained by a person, including mental anguish or death resulting from any of these at any time. 6. BROADENED NAMED INSURED Section II - Who Is An Insured Is amended to Include as an Insured the following: Any organization which is a legally incorporated entity in which you own a financial interest of more than 50 percent of the voting stock on the effective date of this endorsement will be a Named Insured unblthe 18011I day or the end of the policy period, whichever comes first, provided there is no other similar insurance available to that organization. The insurance afforded herein does not apply to any entity which is also an insured under another policy or would be an Insured under such policy but for Its termination or the exhaustion of Its limits of insurance. T, BROADENED PROPERTY DAMAGE - BORROWED EQUIPMENT, CUSTOMERS' GOODS AND USE OF ELEVATORS The insurance for "property damage" liability Is subject to the following: a. The Damag. To Property exclusion under Section I Coverage A is amended as follows: 1. The exclusion for personal property In the care, custody or control of the insured does not apply to "property damage" to equipment you borrow while at a job site and provided It is not being used by anyone to perform operations at the time of loss. 2. The exclusions for (a) Property loaned to you; (b) Personal property in the care, custody or control of the insured; and (c) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it do not apply to "property damage" to "customers' goods" while on your premises nor do they apply to "property damage" arising from the use of elevators at premises you own, rent, lease or occupy. Subject to the Each Occurrence Limit, the most we will pay for "property damage" to "Customers' Goods" is $25,000 per "occurrence". b. Under Section V - Definitions, the following definition Is added: "Customers' Goods" means goods of your customer on your premises for the purpose of being: 1. Repaired; or 2. Used in your manufacturing process. c. The insurance afforded by this provision is excess over any other valid and collectible property insurance (including any deductible) avanable to the insured whether such insurance Is primary, excess, contingent or VCG 206 02 06 Inc::Iudes ~ed IT8teI1II of InsunInce SeMces Olrce. Inc. Page 30(7 Cop)'rIghI2004. I!I lll! ill!!!!!I! I! I!! !!!11llllllll11 II 11I1I! IIf II