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Home My WebLink AboutInsurance Certificate: RW Hays , C ERTIFICA.-':.i.:"OF L1ABILlTy'INSURANCE,..';'>:,,,;; < DA~~J;~;;O;Y1 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. L._.__ CO.rJi.!'Al'!lES AFFORDING.f.:.oVE~.~GE COMPANY FEDERATED SERVICE INSURANCE COMPANY OR A FEDERATED MUTUAL INSURANCE COMPANY A CORl)," PHOPUCER 8.711 ELLIOTT POWELL BADEN 1521 SW SALMON STREET PORTLAND OR 97205 INSURED 314-757-6 COMPANY B RW HAYS COMPANY .PO BOX 1220 MEDFORD OR 97501 COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN lSSUED TO THE INSURED ~AMED ABOVE. FOR THE POLlCY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH AESP::CT 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 SUCHPQLlCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CT~ j -^~~::~F INSURANCE ..--.- -'-r POLICY NUMBER r~~-~~M~~~~~~ I Pci~;EYI~~~~J~~i SHOULD ANY OF THE ABOVE DESCRIBED PCUCIES BE CANCELLED BEfORE THE EXPlRAnON DATE THEREOf, THE ISSU'..~G COMPANY WILL ENDEAVOR TO MAIL _3.0- DAYS WRITTEN NonCE TO THE CERTIFICATE HOLDER NAMED TO THE lEfT. BUI FAILURE TO MAIL SUCH NOTICE SHALl.. IMPOSE NO 03UGATJQN OR UASIUTY OF ANY KINO UPON THE COMPANY. ITS AGENTS OR REPRfSl:NTATIVES. AUTHORIZED REPRESENTATIVE ~__ ;;;:::::;::::t::::?t{::::;:;::::::;::::m1':niNti~i~;?~;:;X.~1.t~&:1~f~~?li~{~@t~t~mff~':ACO'RD7c'6RPORATr6Nli'$.8ij;, i GENERAL UABIUTY f. ){J COMMERCIAL GENERA..L t.\.AB-iUTY i A n CLAIMS MA.DE j X , OCCUR '~NER'S !. CONTl'lA~"TOR'S PROT I' LJ i : AUTOMOBILE UABlurr IXI ANY AUTO n All OWNED Auros A i I SCHEDULED AUTOS !Xl HIRED AuTOS X N3N.QWNED A,UTOS 07/01/10 07/01/11 9802189 07/01/10 07/01/11 9802189 GARA.GE UABlllTY -1 ANY AUTO EXCESS UABIUTY A XJ UMBREtl.A "'ORM 1 OTHER THAN UMBRELLA fORM WORKERS COMPENSATION AND EMPLOYERS' UAl'!IUTY 9802190 07/01/10 07/01/11 I THE PROPRI~ORI I. P~RTNF.R$I(>:"ECUTIVE OFFICERS Ail::: OTHER iR'NCL ! EXCL DESCflJPTION Of OPERATIONSIlOCA1IONSNEHICLESISPECIAl ITEMS SEE ATTACHED PAGE - CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND OR 97520 101 'ACO"RD;2S,St119SI"'. .' w..::;.',.-':"..... "-:'--;'-':-':':': .-...."f.'. UMITS GH:ERAl AG';;REGA!E __ ,I $ 2.000,000 PRODUCTS. COMPI:e~ :'~~J $ 2.000,000 I PERSONAL & AOV INJURV I $ 1.000,000 I EACH OC':UR~~;Ct:~ . _ I $ 1 ,000,000 I FlA." :JAMAG~ IA:J'I' one lirtll $ 100,000 I Mt:l ~x;;,:;;~ pllrs<.m) I $ . I COMBINED SlNG~~_1 $ 1.000,000 I BODilY INJURY $ (Per Pf!r~()nl I I BODilY INJURY I $ frer ll[:cid~r.tl ! PflO?E~~: DAMAGE I $ I AUTO ONLY. fA ACC1DHlT ! OTHfoR THAN AUTa O;Jl;; I EACH ACC1;;;;;- u;__. I AGGREGATE $ I CACH OCCU'.S,"' 1'10,000,000 1 AGGR'GAT' --:=I~Q,OOO,OOO -.-w~ 51 {;.~y. Olt:' I ~L EACH ACCtDHJT ~ "i~ - _n____ El DISEASE. POlIC" UM1T i $ fL DI5EASi: . EA EMPlOYH:--i $ CERTIFICATE OF INSURANCE INSURED 314-757.6 RW HAYS COMPANY PO BOX 1220 MEDFORD OR 97501 DESCRIPTION OF OPERATlONSlLOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATEHOLDER IS AN ADDITiONAL INSURED FOR GENERAL LIABILITY. CERTIFICATEHOLDER IS AN ADDITiONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. 'THE CITY OF ASHLAND, OREGON AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE INCLUDED AS RESPECT TO DELIVERY OF FUEL THIS INSURANCE IS PRIMARY AND NON-CONTRIBUTORY SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS: CERllFICA TE HOLDER CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND OR 97520 101 (::~.h~"'n~t.... it ~("erTfi:ll C'::'i)\! - refIts FED.COPY J POLICY NUMBER: 9802189 lGr;T.:;t v:?;ry: .-- ". -. 'I r~ ,. . . \}: l~ ,<.~l COMMERCIAL GENERAL LIABILITY CG32611005 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Person(s) Or Organizations Location(s) Of Covered Operations ~ITY OF ASHLAND ANY COVERAGE PROVIDED BY THIS 90 N MOUNTAIN AVE ENDORSEMENT APPLIES ONLY TO THE DELIVERY ASHLAND OR 97520 OF FUEL TO THE CITY OF ASHLAND. I ADDITIONAL INSURED ALSO INCLUDES CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES. I Information reouired to cDmDlete this Schedule if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organizaliDn(s) shown in the Schedule, but only with respecl to liability for "bodily injury", "property damage" or "personal and advertising injury" caused by your ongoing operations for the additional insured(s) at the 10catiDn(s) designated above and only to the extent that such "bodily injury", "property damage" Dr "personal and advertising injury. is caused by your negligence or the negligence of those performing operations on your behalf. RW HAYS COMPANY PO BOX 1220 MEDFORD OR 97501 B. With respect to the insurance afforded to these additional insureds, the fDIIDwing additional exclusion applies: This insurance does not apply to "bodily injury.' Dr "property damage" occurring after: 1. All work, including materials. parts or equipment furnished in cDnnection with such work, on the project (other than service, maintenance Dr repairs) to be performed by or on behalf of the additional insured(s) at the location of .the covered operations 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 Dr subcontractor engaged in performing operations for a principal as a part of the same project. CG32611005 @ ISO Properties, Inc., 2005 Page 1 of 1 ~(.'L;;':;r8~::-: . :ntE,"i>~: C,. :....., ' - GL . (:ind T~)f!T1;:,l' 1.:'":.'2:1 VC'"J:\i f: :JIT '; ~2jr:~' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Ins agreed that insurance provided by any additional insured endorsement is primary coverage. We will not seek contribution from any other insurer when insurance on a non-contributing basis is required by contract. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CG-F-65 (08-03) Policy Number: 9802189 Transaction Effective Date: 07-01-2010 ":'<~h~~";,). ( eft. C:oP\ ~ f;):11S ;::;ptl \,~;~''"''::;lt i:'::\' frr.., c.-,-dn'l , ...Ii . \.), t';J" '-- THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the fDIIDwing: BUSINESS AUTO COVERAGE PART With respect to coverage provided lJy this endorsement, the provisions of the Coverage Form apply unless modified lJy the endorsement. A. WHO IS AN INSURED for" 1J0dily injury" and"' property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury Dr property damage "'auto"' lialJility insurance arising out of operation of a covered "'auto'. with your permission. However, this additional insurance does not apply to: (1) The owner Dr anyone else from whDm you hire Dr borrow a covered "'auto"'. This exception does not apply if the covered "auto.' is a "'trailer" connected to a covered "'auto"' you own. (2) You.r .'employee" if the covered "'auto"' is Dwned lJy that "'employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing. repairing, parking or storing "'autos" unless that business is yours. (4) Anyone other than your "employees'., partners (if you are a partnership), members (if you are a limited liability company), Dr a lessee or borrower or any of their "employees", while rroving property to Dr from a covered "auto". . (5) A partner (if you are a partnership), or a member (if you are a limited lialJility company) for a covered "auto"' owned by him Dr her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured. or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance affDrded to any person or organization as an insured under this endorsement does not apply: 1. To "loss"' which occurs prior to the date of your contract with such person or organization: 2. To "'loss"' arising out of the sole negligence of any person Dr Drganization L'1at would not be an insured except for this endorsement. 3. To "'loss"' for any leased Dr rented .. auto"' when the lessor or his or her agent takes possession of the leased or rented" auto"' or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-127 (03-03) Policy NumlJer: 9802189 Transaction Effective Da\e:C7-G1-2010