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ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
11/27/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The HDH Group, Inc. P&G ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
US Steel Tower, Suite 1100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
600 Grant Street
Pittsburgh, PA 15219.2804 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Travelers Property Casualty of Amer 25674
WESCO International, Inc. & INSURER B: American Guarantee & Liability Ins. 26247
WESCO Distribution, Inc. INSURER c:
225 West Station Square, Suite 700 INSURER D:
Pittsburgh, PA 15219 INSURER E:
Client#. 19051
WESCO
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 ~~~~ PJ>1-~~~~~~~8tW\E Pg~fJI~~~~N
LTR TYPE OF INSURANCE POLICY NUMBER LIMITS
A GENERAL LIABILITY TC2JGLSA466K204A TI 06/04/07 06/04/08 EACH OCCURRENCE $1 000 000
I-- DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY P $300 000
f-- ~ CLA.!MS MADE ~ OCCUR iviED EXP (Anyone person) $10.000
f-- PERSONAL & ADV INJURY $1 000000
I-- GENERAL AGGREGATE $4.000 000
n'L AGGREnE LIMIT APAS PER PRODUCTS - COMP/OP AGG $4 000 000
PRO-
POLICY JECT LOC
A ~OMOBILE LIABILITY TC2JCAP466K2026TIL 06/04/07 06/04/08 COMBINED SINGLE LIMIT
.!.- ANY AUTO (Ea accident) $2,000,000
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
f--
r!- HIRED AUTOS BODILY INJURY
$
X NON-OWNED AUTOS (Per accident)
f--
X Physical Damage PROPERTY DAMAGE
is Self-Insured (Per accident) $
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
B ~ESS/UMBRELLA LIABILITY AUC374484307 06/04/07 06/04/08 EACH OCCURRENCE $5 000.000
X OCCUR D CLAIMS MADE AGGREGATE $5.000.000
$
~ DEDUCTIBLE $
X RETENTION $0 $
A WORKERS COMPENSATION AND TC2JUB466K197007 06/04/07 06/04/08 X I T~~J;r~~~;, I IOJ~-
A EMPLOYERS' LIABILITY TRJUB466K198207 06/04/07 06i04/08 $1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE F.L. EACH AI;CIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under $1,000,000
SPECIAL PROVISIONS below E.L, DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
WESCO International, Inc., WESCO Distribution, Inc. & any other organization, other than
a partnership or joint venture, over which WESCO maintains ownership or majority interest ~
on the effective date of the above referenced policies are included as Named Insureds. ~2-0 7 9 b ;2,.---
(:iTY RECORDER i ,
(See Attached Descriptions) (V?l'- 12- C;:J~ ~~" '<Jd--....
( , -v A-
CERTIFICATE HOLDER CANCELLATION ... (/ t/ )
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -30...... DAYS WRITTEN
Mountain Avenue Substation NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Scott Johnson IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
90 North Mountain Ave. REPRESENTATIVES.
Ashland, OR 97520 A~~JZ~~.RE~R:MTA~~l lJ, r~4A
ACORD 25 (2001/08) 1 of 3
#S172194/M160391
SZO
@ 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 25-5 (2001/08) 2 of 3
#S172194/M160391
DESCRIPTIONS (Continued from Page 1)
This certificate will not a',ltomatically renew upon expiration.
Requestor: T. Emmendorfer
Branch:#7672
Re: Project No. 903209.02
It is agreed that Hamby-Young and City of Ashland are included as
Additional Insured as respects the Distribution Rack Expansion Project
Steel Structures and Electrical Equipment.
AMS 25.3 (2001/08)
3 of 3
#S172194/M160391