HomeMy WebLinkAboutInsurance Certificate: OBEC Consulting Engineers
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CERTIFICATE OF LIABILITY INSURANCE
Client#: 331197
DATE (MMfOOfYYYY)
09/27/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. 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 endo
PRODUCER
Kibble & Prentice, a USI Co.
P.O. Box 370
Seattle, WA 98111
206 441-6300
INSURED I V n
OBEC Consulting Engmeeo{;, Ill"c.
920 Country Club Rd. #100B
Eugene, OR 97401
SEP t Ii ,G: J
NAME:
r;:)gNJo Ex!: 206 441-6300
A~D'll~SS: pJ.certrequest@kpcom.com
Ale. No, 610-362-8528
CUSTOMER 10 #:
INSURER(S) AFFORDING COVERAGE
INSURER A: Hudson Insurance Company
INSURER B :
INSURER C :
INSURER 0:
INSURER E :
INSURER F :
NAIC#
25054
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN,.~R TYPE OF INSURANCE IN~~L ~~R POLICY NUMBER P3~:8~~ P3~:8~~ LIMITS
GENERAL LIABIUTY EACH OCCURRENCE ,
- ~~~~J YE~~t:~nce\
COMMERCIAL GENERAl liABiliTY ,
I CLAIMS-MADE 0 OCCUR MED EXP (Anyone person) ,
- PERSONAL & ADV INJURY ,
- GENERAL AGGREGATE ,
~'L AGGREAE LIMIT APMS PER: PRODUCTS - COMPIOP AGG ,
POLICY ~~RT LOC ,
AUTOMOBILE UABILITY COMBINED SINGLE LIMIT ,
- (Eaaccident)
- ANY AUTO 11 BODILY INJURY (Per person) ,
.'
- ALL OWNED AUTOS ,
BODILY INJURY (Per accident)
- SCHEDULED AUTOS 2Ji'l PROPERTY DAMAGE
HIRED AUTOS OCT - 5 (Per accident) ,
-
NON-OWNED AUTOS ,
- -.
I - -----. -- -- ,
UMBRELLA LIAB H ~CCUR t EACH OCCURRENCE ,
- L_..__ - -
EXCESS UAB CLAIMS-MADE AGGREGATE ,
- ,
- DEDUCTIBLE
RETENTION , ,
WORKERS COMPENSATION Iwe STATU. I IgJH.
AND EMPLOYERS' LIABILITY YfN
ANY PROPRIETORlPARTNERfEXECUTIV8 EL EACH ACCIDENT ,
OFFICER/MEMBER EXCLUDED? NfA
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $
~~~c~f~irg~ ~~~PERATIONS below E.L. DISEASE. POLICY LIMIT ,
A Professional AEE7254300 9/25/2010 09/25/2011 $2,000,000 per claim
Liabilitv $4,000,000 ann! aggr.
DESCRIPTION OF OPERATIONS f LOCATIONS {VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
Re: Project No. 05-15, Railroad Crossing Improvement.
~~'1. I k.,,~ 'S.>r. Q."... \ CAc~'S:.~ f\.~
CERTIFICATE HOLDER
CANC
10 D
f N P
t
ELLA TION avs or on- avrnen
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
Engineering Dept.
20 East Main Street AUTHORIZED REPRESENTAllVE
Ashland, OR 97520 -v\A .-. J/!.
I
ACORD 25 (2009/09) 1 of 1
#S4821171/M4821152
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