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HomeMy WebLinkAboutInsurance Certificate: Batzer Inc .::t' <:: 0.\ ~ ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 S...I DATE (MMlDDIYYYY) BATZE-1"1 04/30/09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PROOUCER Anchor Insurance - Portland 1201 SW 12th Ave., Suite 500 Portland OR 97205-2030 Phone: 503-224-2500 Fax:,503-224-9830 .. ." '...'...' INSURERS AFFORDING COVERAGE':' - ... -.... ":~:':.' INSURER A: Bi tuminous Ca:~:b.laltv C-orn':~ :-i' :-'!-~~;(l!!r;-F.v-;G~!G'E.,l 1-;- "NAIC #'--~. -- .-. INSURED :~::~-i'l't,,":I., INSURER B: ; -, "Batzer-'tnc-. --.---:---.---------.- ,--.JPO-Box-,4460... .--.! '_..Medford OR 97501 ; I _,' ,., ,.~, ....~.~ .~., j COVERAGES INSURER C .- " - , , , INSURER 0: , INSURER E: l; _... "'~-'._ ,..\ , b~;c-bt.S'.i;' !J..\'~...(;~ I'" .-,;-,:';"',.":,-, ,"-' THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ,- ANY REQUIREMENT, TERM OR cor.lDmON 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 PAlO CLAIMS. "'r,DD'q' POLICY NUMBER '1~'<<1;Tq'f."i'EC:w."lI'?mY,~~U\!,~~N LIMITS L TR NSRD TYPE OF INSURANCE DATE MMlDDIYY DATE MMlDDIYY - ~NERAL LIABILITY EACH OCCURRENCE .1,000,000 A X X COMMERCIAL GENERAL LIABILITY CLP 3263280 05/01/09 05/01/10 PREMISES (E~~~~~nce) . 300,000 I CLAIMS MA~E ~ OCCUR MED EXP (Anyone person) . 10,000 - PERSONAL & ADV INJURY .1,000,000 - GENERAL AGGREGATE .2,000,000 ~'~ f'.GG~EriflE LIMIT AP~S PER: PRODUCTS. COMP/O? AGG .2,000,000 POLICY X ffg'i LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT .1,000,000 A ~ ANY AUTO CAP 3529600 05/01/09 05/01/10 (Ea accident) - ALL OWNED AUTOS , BODILY INJURY . , SCHEDULED AUTOS . '. (Per person), .. .~ r :\ .- .",.., .,., ... ~ .. -_..,-_.._~_.-. -.,.... ---_... .- .---. ..' ..~ -.- ..' -" '.. -.. .. - .. .. .-. - . - .. ..... ... HIRED AUTOS l'~" ..:>.\ BODlL Y INJURY $-- ___-0-- .. .-..- ,.-. ,~._- ~. NON-OWNED AUTOS-'----~o," ,--_.-- ._~_._..._~_.. --- --_._.._.~_."'- -- -.-.'--'--' - '(Per accident) .. -~. ~- I lh:~n~;::..!::- , ~:-fh. ::;:f; ,-.;:: ~_' ~.lc~~ 1___ - . _._-- -- ---- - - .- ....- ..... -- - ! ~;..~!:~. :::t.' :; PROPERTY DAMAGE I , .. .$..!--. ----.-- ...:'-' ...-'- .... ,-,.' ..- .n' " --- ---. - --..--- (Peraccidenl)-- --.---" -"-:~'.J ~.;....:.;: -_eJC' 'j (~.'>-7L'r-~ , I . -- .- ... --- . -----. - ~RAGE LIABILITY r;o::'" ;;:F: - "~:UTO ONLY: EAACCIDENT . "_ +._ u - ---. . .. .. __.n+______. ..__ ___u - .. .. -." -... .-.- . ANY AUTO .. - - . :,' :-:.' .( ;~ .- - - -'~'" ~ '. 'EAACC . !'.;': .. . ,. "k' .. 'OTHER THAN 0 ..--- .. ... '.. ..--- - .. . A,UTO ONLY: .. .. AGG . .- ~ESS/UMBRELLA LIABILITY EACH OCCURRENCE .5,000,000 A X OCCUR 0 CLAIMS MADE CUP 2584909 05/01/09 05/01/10 AGGREGATE .5,000,000 . ;=J DEDUCTIBLE . X RETENTION $10 000 . WORKERS COMPENSATION ANO I T~~l~t,Ws I IO~~' EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT . OFFfCERfMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ ~t~~~~s~~b~v~~?6~s bel~w E.L. DISEASE. POLICY LIMIT . OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS RE: ENCLOSURE OF METAL BUILDING AT 90 NORTH MAOUNTAIN AVENUE - ASHLAND, OR THE CITY OF ASHLAND, OREGON, ITS OFFICERS, EMPLOYEES AND AGENTS ARE ADDITIONAL INSUREDS PER ATTACHED ENDORSEMENT GL 3084 (01/06) WHICH FOR.MS A PART OF THE INSURED1S GENERAL LIABILITY POLICY. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND DEPARTMENT OF PUBLIC WORKS 20 EAST MAIN STREET ASHLAND OR 97520 ASHLA-l SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE.THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZ R @ CORD CORPORATION 1988 ACORD 25 (2001108) B,ATZER INC, POLICYNO, CLP 3623280 A partnership or joint venture, not shown as a Named Insured in the Declarations, of which you have 33% or more ownership interest at the time of 'bodily injury' or 'property damage' caused by an 'occurrence' or 'personal and advertising injury' caused by an offense, is an insured, provided that no other simiiar liability insurance is available to that partnership or joint venture. B, CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE SECTION II . WHO IS AN INSURED is amended to include: Any 'owner', 'contractor', 'construction manager", 'engineer" or 'architect" if it is required in your written contract or written agreement executed by you and all other parties to the contract or agreement prior to any loss that such person(s) or organization(s) be added as an additionai insured on your policy but only for the project designated in your written contract or written agreement and only with respect to 'bodily injury," "property damage" or 'personal and advertising injury' caused, at least in part, by your negligence and with respect to liability resulting from: A. Your ongoing operations for the additional insured(s), or B. Acts or omissions of the additional insured(s) in connection with their general supervision of such operations. With respect to the insurance afforded such additional insureds pursuant to this endorsement and the above referenced Generai Liability Form, the following additional provisions apply to limit that coverage: 1, We will have no duty to defend the additional insured against any 'suit' seeking damages for 'bodily injury,' 'property damage' or 'personal and advertising injury,' until we receive written notice from the additional insured requesting that we defend it in the 'suit.' 2. The Limits of Insurance applicable to the additional insureds under this endorsement are the minimum limits specified in the written contract or agreement requiring this coverage, or as stated in SECTION III . LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABilITY COVERAGE FORM, whichever is less. These Limits of Insurance are inclusive of and not in addition to the Limits of Insurance described in SECTION III of that form. 3. As additionai conditions of coverage under this form, an additional insured under this endorsement will as soon as practicable: a. Give written notice to us of an "occurrence' or an offense which may result in a claim. This shall include: (1) How, when and where the 'occurrence' or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the 'occurrence' or offense. b. Give written notice to us of a claim or "suit' brought against the additional insured including specifics of the claim or 'suit' and the date it was received. c. Give written notice of such claim or "suit," including a demand for defense and indemnity, to any other insurer who had coverage for the claim or 'suit" under its policy(ies), either at the time of, or at any time subsequent to the occurrence of the "bodily injury," 'property damage" and/or the offense causing the "personal and advertising injury," which is the basis for such claims or "suW. (1) Such notification must demand the full coverage available under that policy; and GL-3084 (01/06) -2- (2) The additional insured shall not take any action to waive or limit such other coverage available to it. 4. This insurance does not apply to: a. "Bodily injury" "property damage" or "personal and advertising injury" occurring after: (1) All work on the project (other than service, maintenance, or repairs) to be performed by you or on your behalf for the additional insured(s) has been completed; or (2) 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 performing operations for a principal as a part of the same project. - b. 'Bodily injury' 'property damage' or 'personal and advertising injury" :resulting from any act or omission of the additional insured(s) or any of their employees, other than the general supervision of work performed for the additional insured(s) by you. c... ,~.Bodily. injury' .:'property. damage' .or. 'personal. and advertising injury'\;.resulting.'fiom' work performed on a project where other valid and collectible insurance is available to the additional insured under an Owner Controlled Insurance Program or Consolidated (wrap-up) Insurance Program. d. 'Bodily injury,' 'property damage" or 'personal and advertising injury': (1) Arising out of the rendering or failure to render any professional services by any insured, or on their behalf, but only with respect to either or both of the following operations; (a) Providing engineering, architectural or surveying services to others in the insured's capacity as an engineer, architect or surveyor, and (b) Providing, or hiring independent professionals to provide, engineering, architectural or surveying services in connection with work the insured performs. (2) Subject to paragraph (3) below, professional services include: (a) The preparing, approving or tailing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b) Supervisory or inspection activities performed as part of any related architectural or engineering activities, but does not include the general supervision ot your operations on such project. (3) Prolessional services do not include services within construction means, techniques, sequences and procedures employed by you in connection operations as a construction contractor. methods, with your For the purpose of this endorsement, the following definitions are added: . "Owner" means a person or organization who has ownership in the project premises, designated in your writlen contract or written agreement, at which you are performing operations. "Contractor" means a person or organization with whom you have agreed in a written contract or writlen agreement to perform operations for at the project designated in the written contract or written agreement. GL-3084 (01/06) -3- 6") "."'.' :~., :: f?!~ -;;:;';1< 'Construction Manager' means a person or organization designated as 'construction manager' In your written contract or written agreement, and has management or supervisory responsibilities over your operations for the project designated in your written contract or written agreement. 'Engineer' means a person or organization who has been engaged by the 'owner', 'contractor' or 'construction manager' to perform engineering services for the project designated in your written contract or written agreement and has a contractual responsibility for supervising, directing or controlling your operations on such project. 'Architect' means a person or organization who has been engaged by the 'owner', 'contractor' or 'construction manager' to perform architectural services for the project designated in your written contract or written agreement and has a contractual responsibility for supervising, directing or controiling your operations on such project. Any coverage provided herein will be excess over any other valid and collectable insurance available to the additional insured(s) whether primary, excess, contingent or on any other 'basis unless you have agreed in a written contract or written agreement executed prior to any loss that this insurance will be primary. However, any other insurance specifically purchased for a designated project(s), Including but not limited to additional insured coverage, owners contractors protective coverage, etc., will be primary with . the Insurance provided by this endorsement being excess. If this insurance is determined to be primary, we agree not to seek contribution from such other insurance oniy if you have so agreed in the written contract or written agreement. C. AlITOMATlC WAIVER OF SUBROGATION Item 8. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced with the following: 8. Transfer of Rights of Recovery Against Others to Us and Automatic Waiver of Subrogation. a. If the insured has. rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring 'suit' or transfer those rights to us and help us enforce them. b. If required by a written contract executed prior to loss, we 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 work' for that person or organization. D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL Item A.2.b. of the COMMON POLICY CONDITIONS, is deleted,and replaced with the following: A.2.b. 60 days before'the elfective date of the cancellation if we cancel for any other reason. Item 9. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced with the following: 9. WHEN WE DO NOT RENEW a. If we choose to nonrenew.this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. b, 'If we'do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you may extend the period of this policy for a maximum additional sixty(60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not GL-3084 (01/06) -4- BATZER INC. POLICYNO. CLP 3623280 A partnership or joint venture, not shown as a Named Insured in the Declarations, of which you have 33% or more ownership interest at the time of "bodily injury" or "property damage' caused by an 'occurrence' or 'personal and advertising injury" caused by an offense, is an insured, provided that no other similar liability insurance is avaiiable to that partnership or joint venture. B. CONTRACTORS AUTOMATIC ADDrrlONAL INSURED COVERAGE SECTION II . WHO IS AN INSURED is amended to Include: Any 'owner', 'contractor', 'construction manager', 'engineer' or 'architect' if it is required in your written contract or written agreement executed by you and all other parties to the contract or agreement prior to any loss that such person(s) or organization(s) be added as an additional insured on your policy but only for the project designated in your written contract or written agreement and only with respect to 'bodily injury,' 'property damage" or 'personal and advertising injury" caused, at least in part, by your negligence and with respect to liability resulting from: _' A. Your ongoing operations tor the additional insured(s), or B. Acts or omissions of the additional insured(s) in connection with their general supervision of such operations. With respect to the insurance afforded such additional insureds pursuant to this endorsement and the above referenced General Liability Form, the following additional provisions apply to limit that coverage: 1. We wiil have no duty to defend the additional insured against any 'suit' seeking damages for 'bodily injury,' 'property damage' or 'personal and advertising injury,' until we receive written notice from the additional insured requesting that we defend it in the 'suit.' 2. The Limits of Insurance applicable to the additional insureds under this endorsement are the minimum limits specified in the written contract or agreement requiring fhis coverage, or as stated in SECTION III . LIMITS OF INSURANCE of the COMMERCIAL GENERAL LiABILITY COVERAGE FORM, whichever is less. These Limits of Insurance are inclusive of and not in addition to the Limits of Insurance described in SECTION III of that form. 3. As additional conditions ot coverage under this torm, an additional insured under this endorsement will as soon as practicable: a. Give written notice to us of an 'occurrence" or an offense which may result in a claim. This shall include: (1) How, when and where the 'occurrence' or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence' or of tense. b. Give written notice to us of a claim or 'suit" brought against the additional insured including specitics of the claim or 'suit' and the date it was received. c. Give written notice of such claim or "suit," inciuding a demand for defense and indemnity, to any other insurer who had coverage for the claim or "suit" under its policy(ies), either at the time of, or at any time subsequent to the occurrence of the "bodily injury," "property damage" and/or the offense causing the "personal and advertising injury," which is the basis for such claims or "suit". (1) Such notification must demand the full coverage available under that policy; and GL.3084 (01/06) .2- (2) The additional insured shall not take any action to waive or limit such other coverage available to it. 4. This insurance does not apply to: a. "Bodily injury" "property damage" or "personal and advertising injury" occurring after: (1) All work on the project (other than service, maintenance, or repairs) to be performed by you or on your behalf for the additional insured(s) has been completed; or (2) 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 performing operations for a principal as a part of the same project. b. 'Bodily injury' 'property damage' or 'personal and advertising injury" :resulting from any act or omission of the additional insured(s) or any ot their employees, other than the general supervision of work performed for the additionai insured(s) by you. c, 'Bodily. injury' 'property damage' or 'personal and advertising injury" resulting 'from work p~rfornied on a project where other valid and collectible insurance is available to the additional insured under an Owner Controlled Insurance Program or Consolidated (wrap-up) Insurance Program. d. 'Bodily injury,' "property damage' or 'personal and advertising injury': (1) Arising out of the rendering or failure to render any professional services by any insured, or on their behaif, but only with respect to either or both of the following operations: (a) Providing engineering, architectural or surveying services to others in the insured's capacity as an engineer, architect or surveyor, and (b) Providing, or hiring independent professionals to provide, engineering, architectural or surveying services in connection with work the insured performs. (2) Subject to paragraph (3) below, professional services include: (a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b) Supervisory or inspection activities performed as part of any related architectural or engineering activities, but does not include the general supervision ot your operations on such project. (3) Professional services do not include services within construction means, techniques, sequences and procedures employed by you in connection operations as a construction contractor. methods, with your For the purpose of this endorsement, the following definitions are added: "Owner" means a person or organization who has ownership in the project premises, designated in your written contract or written agreement, at which you are performing operations. "Contractor' means a person or organization with whom you have agreed in a written contract or written agreement to perform operations for at the project designated in the written contract or written agreement. GL-3084 (01/06) -3- , . .:.{0) /';t~ :):::.} 'Construction Manager' means a person or organization designated as 'construction manager' in your written contract or written agreement, and has management or supervisory responsibilities over your operations for the project designated in your written contract or written agreement. 'Engineer' means a person or organization who has been engaged by the 'owner', 'contractor' or 'construction manager' to perform engineering services for the project designated in your written contract or written agreement and has a contractual responsibility for supervising, directing or controlling your operations on such project. ' 'Architect' means a person or organization who has been engaged by the 'owner', 'contractor' or 'construction manager' to perform architecturai services for the project designafed in your written contract or written agreement and has a contractual responsibility for supervising, directing or controiling your operations on such project. Any coverage provided herein will be excess over any other valid and collectable insurance available to the additional insured(s) whether primary, excess, contingent or on any other 'basis unless you have agreed in a written contract or written agreement executed prior to any loss that this insurance will be primary. However, any other insurance specifically purchased for a designated project(s), including but not limited to additional insured coverage, owners contractors protective coverage, etc., will be primary with the insurance. provided by this endorsement being'excess. If this insurance is determined to be primary, we agree not to seek contribution from such other insurance only if you have so agreed in the written contract or written agreement. C. AUTOMATIC WAIVER OF SUBROGATION Item 8. of SECTION IV . COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced with the following: 8. Transfer of Rights of Recovery Against Others to Us and Automatic Waiver of Subrogation. a. If the insured has rights to recover ali or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured wiil bring 'suit' or transfer those rights to us and help us entorce them. b. If required by a written contract executed prior to loss, we 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 work' for that person or organization. D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL Item A.2.b. of the COMMON POLICY CONDITIONS. is deleted and replaced with the following: A.2.b. 60 days before'the effective date of the cancellation if we cancel for any other reason. Item 9. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS. is deleted and replaced with the foil owing: 9. WHEN WE DO NOT RENEW a. If we choose to nonrenew this policy. we will mail or deliver to the first Named Insured shown in the Declarations written notice of the non renewal not less than 60 days before the expiration date. b. If we do not give notice of our intent to nonrenew as prescribed in a. above. it is agreed that you may extend the period of this policy for a maximum additional sixty(60) days from its scheduled expiration date. Where not otherwise prohibited by iaw. the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not GL-3084 (01/06) -4-