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Home My WebLink AboutInsurance Certificate: Cooperative Personnel Services CITY RECORDER 'ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/ODIYYYY) 7/6/2009 PRODUCER Phone: 877-222-0000 Fax: 916-925-3595 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION James C. Jenkins Insurance Service, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR License # 0545478 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 13847 Sacramento CA 95853 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Casual tv & Suret" Co Cooperative Personnel Services INSURERS: Travelers Pronertv Casual tv b5674 dba CPS, Human Resource Services 241 Lathrop Way INSURER c' Sacramento CA 95815 INSURER 0: 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. IN~: ~r:,~; POLICY NUMBER P~A~~ EFFECTIVE POLICY EXPIRATION LIMITS B X ~NERAL LIABILITY P6307704A197 7/1/2009 7/1/2010 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY ~~~~ISES Eaoccurence\ '500 000 I CLAIMS MADE [iJ OCCUR MED EXP (Anyone person) no 000 - PERSONAL & ADV INJURY $1 000 000 - GENERAL AGGREGATE '2 000 000 ~'LAGG~EnELlMITAPnPER: . PRODUCTS.COM~OPAGG '2 000 000 POLICY ~~?,: LOC B ~TOMDBILE LIABILITY P8107704A197 7/1/2009 7/1/2010 COMBINED SINGLE LIMIT '1,000,000 ANY AUTO (Eaaccidenl) f- f- ALL OWNED AUTOS BODILY INJURY . SCHEDULED AUTOS (Per person) f- lL HIRED AUTOS BODILY INJURY (Peraccidenl) . lL NON-OWNED AUTOS - PROPERTY DAMAGE . (Per accident} ~RAGE LIABILITY AUTO ONLY - EAACCIDENT . ANY AUTO OTHER THAN EAACC . AUTO ONLY: AGO . B ~ESSlUMBRELLA LIABILITY PFSEX7704A197 7/1/2009 7/1/2010 EACH OCCURRENCE '5 000 000 X OCCUR D CLAIMS MADE AGGREGATE . 5 000 000 . 8 DEDUCTIBLE . X RETENTION 'NIL . A WORKERS COMPENSATION AND PACRUB1l76A22009 7/1/2009 7/1/2010 X I T~~~T~T.lf" I IOJ~. EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE EL EACH ACCIDENT '1 000 000 OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $1 000 000 ~~~~I~Cr;~O~IS:ONS below EL DISEASE. POLICY LIMIT $1 000 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS E: services performed by or on behalf of the named insured. The City of Ashland, Oregon and its elected officials, officers and employees are Additional Insureds per the attached form. 10 days notice of cancellation will apply if cancelled for non-payment of premium. E-..p ~ ~12..~s ~l"~ P-o. 067q 0 ) City of Ashland 90 N. Mountain Avenue Attn: Kari Olson Ashland OR 97520 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) Policy # P6307704A197 Effective 7/1/09 to 7/1/10 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1, WHO IS AN INSURED - (Section 11) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only 10 the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. -_ 2, The insurance provided to the additional insured by this endorsement is limited as foliows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III - Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury". "prop- erty damage" or "personai injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services. including: i, The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, . approving, or' failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply 10 "bodily injury" or "property damage" caused by "your work" and included in the "products-completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance. provided to the additionai insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The Insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additionai insured for a ioss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additionai insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured. by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis. that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4, As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possibie, such notice should include: CG 02 46 08 05 @2005 The Sl. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii, The names and addresses of any injured persons and witnesses; and iii, The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: j, Im'mediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with ali policy condtlions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additionai insured which covers that person or organization as a named insured as described in paragraph 3, above. 5, The following definition is added to SECTION V. - DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an . offense committed: a, After the signing and execution of the contract or agreement by you; b, While that part of the contract or agreement is in effect; and c, Before the end of the policy period. @2005 The St. Paul Travelers Companies, Inc. CG 02 46 08 05