HomeMy WebLinkAboutSabel Painting
ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP 10 D{ DATE (MMlDDIYYYY)
SABEL-1 11/19/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance Marketp~ace, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1998 Skypark Dr Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504
Phone: 541-779-0177 Fax: FAX 772-8235 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Safeco Ins Co. 24724
INSURER B:
Sabe~ Painting CO INSURER C:
Jim Sabe~
3181 O~d Sta~e Rd INSURER D:
.Centra~ Poin OR 97502
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.
LTR NSRf TYPE OF INSURANCE POLICY NUMBER PD~IfE iMMlDDIYY I P8k'fEY,MMlDDIVYIN LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 1000000
A X X COMMERCIAL GENERAL LIABILITY 01-CG-910242-3 11/14/07 11/14/08 PREM~ESIEao~u~nce) $ 200,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000
- PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ 2000000
4 n-PRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
--.:.. $
ANY AUTO (Ea a~ident)
-
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
(Per a~ident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $
tJ OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
-
. RETENTION $ $
WORKERS COMPENSATION AND I TORY LIMITS I l"F
ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~~~I~tS~~~~~?~~s below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Ash~and, its officers, emp~oyees and agents are additiona~
insured
~(j #: tJ 7q ~8
CERTIFICATE HOLDER
CANCELLATION
ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ash~and M~ Officers DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
and Emp~oyees NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Kari O~son IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
20 E. Main St.
Ash~and OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Kevin Cone
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988
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.
r::Gl SAFECOo
r~
CG 76 35 10 00
LIABILITY PLUS ENDORSEMENT
COMMERCIAL GENERAL LIAS/LIlY
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL L1ABILllY COVERAGE PART
SCHEDULE
Name of Person or Organization:
City of Ashland
ADDITIONAL INSURED . BY WRITTEN CONTRACT,
AGREEMENT OR PERMIT, OR SCHEDULE
Tile following paragraph is added to WHO IS AN INSURED
(Section II):
5. Any person or organization shown in the Schedule or
for whom you are requ ired by written contract,
agreement or permit to provide insurance is an
Insured, sUbject to the following additional provisions:
a. The contract, agreement or permit must be in
effect during the polley period shown in the
Declarations, and must have been executed prior
to the "bodily injury," "property damage,"
"personal and advertis ing injury."
b. The person or organization added as an insured
by this endorsement is an insured only to the
extent you are held liable due to:
(1) The ownership, maintenance or use of that
part of premises you own, rent, lease or
occupy, subject to the following additional
provisions:
(a) This insurance does not apply to any
"occurrence" which talms place after
you cease to be a tenant In any
premises leased to or rented to you;
(b) This insurance does not apply to any
structural alterations, new construction
. or demolition operations performed by
or on behalf of the person or
organization added as an Insured;
(2) Your ongoing operations for that insured,
whether the work is performed by you or for
you;
(3) The maintenance, operation or use by you
of equipment leased to you by such person
or organization, subject to the following
additional provisions:
(a) This Insurance does. not apply to any
"occurrence" which lakes place after
the equipment lease expires:
(b) This insurance does not apply to
"bodily injury" or "property damage"
arising out of the sole negligence of
such person or organization:
(4) Permits issued by any state or political
subdivision with respect to operations
performed by you or on your behalf, subject
to the following additional provision:
This insurance does not apply to "bodily
injury," "property damage," "personal and
advertising injury" arising out of operations
performed for the state or municipality:
c. Tile insurance with respect to any architect,
engineer, or sUlveyor added as an insured by this
endorsement does not apply to "bodily injury,"
"property damage," "personal and advertising
injury" arising out of the rendering of or trle
failure to rencler any professional services by or
for you, Including:
(1) The preparing, approving, or failing to
prepare or approve maps, drawings,
opinions, reports, surveys, change orders,
designs or specifications; and
(2) Supervisory, inspection or engineering
services.
d. This insurance cloes not apply to "bodily injury"
or "property damage" included wit~lin ttle
.. products-completecl operations Ilazard."
A person's or organization's status as an insured
under tllis endorsement encls W~len your
operations for IIlat insured are completed.
No coverage will be provided if, in ttle absence
of ttlis endorsement, no lialJility would be
imposecl b~f law on you. Coverage s~lall be limited
to the extent of your negligence or fault according
to the applicable principles of comparative fault.
NON-OWNED WATERCRAFT AND NON-OWNED AIRCRAFT
LIABILITY
Exclusion g. of COVERAGE A (Section I) is replaced by t~le
following:
g. II Bodily injury" or "property damage" arising out
of t~le ownersllip, maintenance, use or
entrustment to otllers of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insurec!. Use inclueles operation
and "loading or unloading."
T~lis exclusion does not apply to:
(1) A watercraft while aS~lOre on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less tllan 52 feet long; and
(b) Not being useel to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not ownecl by or rented or loaned
to you or tile insured;
(4) Liability assumed uncleI' any "insurecl
contract" for tile owners~lip, maintenance or
use of aircraft or watercraft; or
(5) "Bodily injury" or "property damage"
arising out of the operation of any of the
equipment listed in paragraph f.(2) or f.(3)
of t~le definition of "mobile equipment."
(6) An aircraft you do not own provided it is not
operated by any insurec!.
TENANTS' PROPERTY DAMAGE LIABILITY
Wilen a Damage to Premises Rented to you Limit is S~lOwn
in ttle Declarations, Exclusion J. of Coverage A, Section I is
replaced by tile following:
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy;
( "
eG 76 35 10 00
COMMERCIAL GENERAL LIABILITY
(2) Premises you sell, give away or abanclon, if the
"property clamage" arises out of any part of
trIOse premises;
(3) Property loaned to you;
(4) Personal property in the care, custody or control
of the insured;
(5) TrIal particular part of real property on whicll you
or any contractors or sulJcontractors working
clireclly or indirectly on your behalf are
performing operations, if the" property damage"
arises OLlt of IrlOse operations, or
(6) That particular part of any property that must be
restored, repaired or replacecl because "your
work" was incorrectly performed on it.
Paragrap~\s (1), (3) and (4) of nlis exclusion do not
apply to "property damage" (ottler than damage by
fire) to premises, including nle contents of such
premises, rented to you. A separate limit of insurance
applies to Damage To Premises Rentecl To You as
described in Section III - Limits Of Insurance.
Paragrap~\ (2) of ttlis exclusion does not apply if nle
premises are "your work" and were never occupied,
rented or held for rental by you.
Paragraphs (3), (4), (5) and (5) of this exclusion do
not apply to liability assumed uncler a sidetrack
agreement.
Paragraph (5) of this exclusion ~Ioes not apply to
"property damage" included in the
"products-completed operations flazard."
Paragraph 6. of Section III is replaced by the following:
6. Subject to 5. above, nle Damage To Property Limit is
nle most we will pay under Coverage A for damages
because of "property clamage" to anyone premises,
while rented to you, or in the case of damage by fire,
wrlile rented to you or temporarily occupied by you
wittl permission of ttle owner.
The Tenants' Property Damage to Premises Renteel to You
limil is HIe higher of $200,000 or !rle amount shown in the
Declarations as Damage to Premises Rented to You Limit.
WHO IS AN INSURED - MANAGERS
The following is added 10 Paragraph 2.a. of WHO IS AN
INSURED (Section II):
Paragraph (1) does not apply to executive officers, or to
managers at the supervisory level Dr above.
SUPPLEMENTARY PAYMENTS . COVERAGES A AND B .
BAil DONDS
a. Paragraph 2. of SUPPLEMENTARY PAYMENTS -
COVERAGES A AND B is replaced IJY the following:
PaQe 2 or 3
2. Up to $2,000 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which ttle
Bodily Injury Liability Coverage applies. We do
not rlave to furnish these bonds.
EMPLOYEES AS INSUREDS - HEALTH CARE SERVICES
Provision 2.a.(1) d. of WHO IS AN INSURED (Section II) is
deleted, unless excluded by separate endorsement.
EXTENDED COVERAGE FOR NEWLY ACQUIRED
ORGANIZATIONS
Provision 4.a. of WHO IS AN INSURED (Section II) is
replaced by ttle following:
a. Coverage under this proVision is afforded only
until the end of the policy period.
EXTENDED" PROPERTY DAMAGE"
Exclusion a. of COVERAGE A. (Section I) is amended to
read:
a. "Bodily injury" or "property damage" expected or
intended from the standpoint of the insured. This
exclusion does not apply to "bodily injury" or
"property damage" resulting from the use of
reasonable force to protect persons or property.
ADDITIONAL INSURED - VOLUNTEERS
1. WHO IS AN INSURED (Section II) is amended to
include as insureds any persons who are volunteer
workers for you, but only while acting at the direction
of, and within the scope of their duties for you.
However, no volunteers are insureds for:
a. "Bodily injury" to:
(1) Co-volunteers or your employees arising out
of and in the course of their duties for you,
or
(2) You, any of your "employees," any partner
or member (if you are a partnership or joint
venture), or any member (if you are a limited
liability company).
b. "Property damage" to property owned, occupied
or used by, rented to, in the care, custody, or
control of, or over which physical control is being
exercised for any purpose by:
CG 76 35 10 00
COMMERCIAL GENERAL L1ABILllY
(1) A co-volunteer or your employee; or
(2) You, any of your" employees", any partner
or member (if you are a partnership or joint
venture), or any member (if you are a limited
liability company).
2. Exclusion 2.a. of COVERAGE C (Section I) is replaced
by the following:
a. To any insured, except volunteer workers wrlO are
not paid a fee, salary or other compensation;
INCREASED MEDICAL EXPENSE LIMIT
The medical expense limit is amended to $10,000.
KNOWLEDGE OF OCCURRENCE
The following is added to Paragraph 2. Duties In The Event
Of Occurrence, Offense, Claim Or Suit of COMMERCIAL
GENERAL L1ABILllY CONDITIONS (Section IV):
Knowledge of an "occurrence," claim or "suit" by your
agent, servant or employee shall not in itself constitute
knOWledge of the named insured unless an officer of the
named insured has received such notice from the agent,
servant or employee.
UNINTENTIONAL FAILURE TO DISCLOSE ALL HAZARDS
The following is added to Paragraph 6. Representations of
COMMERCIAL GENERAL L1ABILllY CONDITIONS (Section
IV):
If you unintentionally fail to disclose any hazards existing
at the inception date of your policy, we will not deny
coverage under ttlis Coverage Form because of such failure.
However, this provision does not affect our right to collect
additional premium or exercise our right of cancellation or
non-renewal.
LIBERALIZATION CLAUSE
The following paragraph is added to COMMERCIAL
GENERAL L1ABILllY CONDITIONS (Section IV):
10. If a revision to this Coverage Part, which would
provide more coverage with no additional premium,
becomes effective during trle policy period in the state
shown in the Declarations, your policy will
automatically provide ttlis additional coverage on the
effective date of t~le revision.
Page 3 of 3