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HomeMy WebLinkAboutInsurance Certificate: Peck Smiley Ettlin Architects ~ .- - f~CORD CERTIFICATE OF LIABILITY INSURANCE "OPID KI I DATE (MMJDDNYYY) 'I' ... PECKS-l 04/08/10 PRCgUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ful1erton__& C~!l\pany ,... HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ., .-_.. P. O. Box 29018 ALTER THE COVERAGE AFFORDED BY,THE POLICIES BELOW. .., Portland OR 97296-'9018 ., , ' INSURERS AFFORDING COVERAGE ">/'/,(t': i' ;Phone; 50~,u.2?4-.~?,g, Fax:503-274-6524 . - . NAIC#, :INSUREO i> , INSURER A: Hartford Casual ty;"l ., I, 29424 , ' ,l~:U::"::i I 1 . 1 The Employer. Fire 'Insurance _206,48. ,_, ! r.:,.:HGPllfED ';.IUOP INSURER B: ',- j , I I , ! j --~eck"'l'Siid'ley Ettlinl Architects INSURER C SAIF Corporation-'J,' I.. , I I , v4412.SW Corbett Avenue~ INSURER 0: New Hampshire Ins. Co. ',Portland OR 97239-4207... 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. ~~Rd TYPE OF INSURANCE POLICY NUMBER ~NERAL LIABILITY A X X COMMERCIAL GENERAL LIABILITY 52SBAUL7992 I CLAIMS MADE [!] OCCUR ~';!~JMMJDDIYYI- PMkh MMJDD1YYIN EACH OCCURRENCE 04/01/10 04/01/11 PREMISES (Ea occurence) MED EXP (Anyone person) GEN'L AGGREGATE LIMIT APPLIES PER: I POLICY n ~f8i n LOC ~T~~~BILE.L1ABILlTY X ANY AUTO,. = .. . _)ALL:'OWNEDAUTOS-...,._ - ~ ~. _......_ ; I - SCHEDULED AUTOS 1 '~~.:r:.! ~~_.~ HIRED_ AUTO_~___ ___ _ ___, ..___ _. ._~ _ I to ~\ ::it: I ;i'" ..~ON..'O_WNEO. A.,__U.,TO, S -~ -- .1.1". ,-- _ I.~;>'.':~')C:"'.S,\\"~2:' I ~.C';. :..:T1. :1"(\ f'''''' ..... : _ ;., : ,.....1) :,) - .- PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG B FFIE06005 ,05/09/09 COMBINED SINGLE LIMIT 05/09/10.. (Eaaccidenl) ._. "'h BODILY INJURY-- (Per person) ~:~.;~~..~. :. "..,.]. '.1-.-.... LIMITS '2000000 . 300000 . 10000 . 2000000 . 4000000 . 4000000 . 1000000 1 .i _.L':~."""k-- '" _ . .'" '. ~":::.\ . '.~ .BODIL Y,INJURY '- '(~raccide~I)_ __ - _. .!, ..:. [..It ; .~~ '.... "<;!. .... ..'. -- -. _.....- I: .:;:r; i :.,. t~ >:..: ..:lh\~.~ PROPERTY DAMAGE (Peraccide~l) C GARAGE LIABILITY =1 ANY AUTO '\,. EXCESS/UMBRELLA LIABILITY ::lOCCUR ---EJ CLAIMS' MADE I DEDUCTIBLE ,_~.RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERlMEMBER EXCLUDED? ~~~~I~ts~~~v~s1~~s below OTHER 978205 AUTO ONLY - EA ACCIDENT OTHER THAN _A~TO ONLY: ',.' 1.. _ EACH OCCURRENCE ,AGGREGATE -~---~..- -,- --.-- - -_. - ,- -- 09/01/09 09/01/10 x I TORY "LIMiTS I IV d:\" E.L EACH ACCIDENT EA ACC AGG . ,- . . . . . . . . . . $ E.L. DISEASE. EA EMPLOYEE $ 500000 E.L.DISEASE-POLlCYLlMIT $ 500000 $ 500000 D Errors & Omissions 12/19/09 Ea Claim Aggregate 12/19/10 4392598901 $10,000 Deductible DESCRIPTION OF OPERATIONS' LOCATIONS 'VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: All Operations Certificate Holder is considered as additional insured with regard to operations of the named insured in accordance with the policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION 1000000 1000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL of Ashland IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER,ITS AGENTS OR 90 North Mountain Ave Ashland OR 97520 REPRESENTATIVES. ~~~J~\Jo--\.. . ACORD 25 (2001/08) @ ACORD CORPOR.~TION 1988 , , . POUCY NUMBER: 52 SBA UL7992 ~ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON-ORGANIZATION en N ..,. .... o CITY OF ASHLAND, IT'S OFFICERS, EMPLOYEES, AND AGENTS 20 EAST MAIN STREET ASHLAND, OR 97520 ::: CITY OF, PORTLAND ::: 1120 SW 5TH AVE, ROOM #1204 ~ PORTLAND, OR 97204-1985. en .... ..:r p N In N o o .... .N . i!!!!!!l - ....... - ..... ~ = .... = === = = --- = --- !I:ZI - - ~ .... """'" - ...... - ...... -- - - - ~ - = - === ..... """" ...... == - === = = --- = """'" --- ...... Fonn IH 12001185TSEQ. NO. 002 PIoc:esa Date: 02/02/10 PrInted In U.s.A. Page 001 Expiration Date: 04/01/11 INSURED COPY ~