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Home My WebLink AboutInsurance Certificate: Marquess & Associates Inc ~ ,""CORD" CERTIFICATE OF LIABILITY . INSURANCE I DATE (MMIODfYYYY) OS/20/2011 THIS CERTIFICATE IS ISSUED AS AMATTER 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 15 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 endorsement(s). PRODUCER Phone: (360) 598-3700 Fax: (36,0) 598-3703 CDNT ACT MICHAEL J. HALL & COMPANY NAME. MiCIjAEL J. HALL & COMPANY - P~N~ Ext': (360) 598~3700 (,F~No': (360) 598-3703 HALL & COMPANY E-MAIL 19660 10TH AVENUE N.E. ADDRESS: PRODUCER 2738 POULSBO WA 98370 CUSTOMER 10 INSURER(S) AFFORDING COVERAGE NAICtI INSURED INSURER A : Travelers Casualty and Surety Co of America 31194 Marquess & Associates Inc The Travelers Indemnity Company of America 25666 PO Box 490 INSURERB Medford, OR 97501-0033 INSURER C The Travelers Indemnity Company 25658 INSURER 0" The Travelers Indemnity Company of America 25666 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 137490 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLlCIES 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. "'~" 'o,~..o ",n, n,,~ '0 , ,,<TO ou~"''' UAV UAH" .M INSR TYPE OF INSURANCE ADDC SUBR POLICY NUMBER POUCY EfF ~L1:~ LIMITS CTR INSR WVD ....IDO B GENERAl... .......UTY 6806148N63A OS/29/11 05129112 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ~~~i~~E~\ $ 300,000 I cLArMiMAoe lXl OCCUR MEO. EXP (Anyone person) $ 5,000 X XCU, BFPD, OCP PERSONAL & A[)V INJURY $ 1,000,000 X Separation of Insureds GENERAl AGGREGATE $ 2,000,000 . ~~ AGGREGATE LIMIT APPl:,PER: PRODUCTS - COMPfOP AGG $ 2,000,000 If: l PRO 1,000,000 POLICY X ,,::~ LOC EMPLOYEE BENEFITS 1I $ D AUTOMOBILE UABIUTY BA6148N401 05129/11 OS/29/12 COMBINED SINGlE LIMIT $ 1,000,000 cc- (Eaaccident) ~ AN'( AUTO BODILY INJURY (Per person) $ .!. AlL OWNED AUTOS BODILY INJURY (Per accident) $ - SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ - - NON..()WNED AUTOS $ $ C X UMBRELLA COAS ~J OCCUR CUP3196T698 OS/29/11 OS/29/12 EACH OCCURRENCE $ 5,000,000 - EXCESS COAS CLAIMs..MADE AGGREGATE $" 5,000,000 - DEDUCTIBLE $ RETENTION , 10,000 . - WORKERS COMPENSATION .) ~~D~~~~" I I DTH $ "'D EMPLOYERS' LIABILITY "" ANY PROPRIETORIPARTNERlEXECUTlVE 0 E.l. EACH ACCIDENT $ OFFICERIIIlEMBER EXCLUDED? "'^ (Mandaory In NH) E.l. DISEASE-EA EMPLOYEE $ If yes, describe under E.l. DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below, $ A Professional Uability: Claims Made Form 105320158 . 07/26/10 07126111 $1,000,000 Per Claim $1,000,000 Aggregate DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Project: Street Improvement Project #2005-34 CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520-1814 AlItHORIZED REPRESENTATIVE Attention: ~Z~ shley L. Hurd ACORD 25 (2009/09) @ 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ~ ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE 1....IOOfYYYY) ~ 05120/2011 THIS CERTIFICATE IS ISSUED I>S~ 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: tf the certificate holder Is an ADDITIONAL INSURED, the pOllcy(ies) 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 endorsement(s). . ,'. . PRODUCER Phone: (360) 598-3700 Fax: (360) 598-3703 : =~CT: MICHAEL J. HALL&.COMPANY.' MICHAEL J. HALL &. COMPANY . P~N:O - ixt~/ _ (3"60) ~598-3700 ., - 'LF~:No'\: (360) 598-3703 > HALL &. COMPANY . ~ E.MAll, ~ . . .:..' '.-. . .. - ....<; ADDRESS- . 19660 10TH AVENUE N.E. .' " .' '. PRODUCER 2738 ~ . ";0; - . . , 0 POULSBO WA 98370 " { CUSTOMER 10- " :. .. INSURER(S) AFFORDING COVER)\GE NAfCI# INSURED INSURER A , Travelers Casualty'andSurety Co' of America 31194 o. Marquess & Associates Inc INSURERS The Travelers tndemnlty Company of ArJ:Ierica 25666 PO Box 490 Medford, OR 97501-0033 INSURER C The Travelers Indemnity Company 25658 INSURER 0: The Travelers Indemnity Company of America 25666 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 137491 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, " c" ,.,nM. 'c, '0' .,,,, .~nWM "'V ~"'" "co~ RV INSR TYPE OF INSURANCE ODDC SUSR POLICY NUMBER ~~~~ ':~~;.~ LIMITS LTR INSR WVD B GENERAL LIABILITY 6806146N63A OS/29/11 OS/29/12 EACH OCCURRENCE, $ 1,000,000 ~ =~~~~~E~\ . X COMMERCIAL GENERAl LIABILITY $ 300,000 I CLAIMS-MADE lXl OCCUR MED. EXP (Anyone person) $ 5,000 X XCU, BFPD, OCP. PERSONAL & AnV INJURY $ 1,000,000 X Separation of Insureds GENERAL AGGREGATE $ 2,000,000 I- 2,000,000 GEN'L AGGREGATE LIMIT APn~IPER:. PRODUCTS - COMP/OP AGG $ II ,II PRO 1,000,000 POLICY X lJ:r; LOC EMPLOYEE BENEFITS LI $ D AUTOMOBILE LIABIUTY BA6148N401 OS/29/11 OS/29/12 COMBINED SINGLE LIMIT $ 1,000,000 ex (Eaaccidenl) ANY AUTO 'x BODilY INJURY (Per person) $ ALL OWNED AUTOS f-- BODILY INJURY (Per accidenl) $ I- SCHEDULED AUTOS PROPERTY DAMAGE $ - HIRED AUTOS (Per accident) - NON-QWNED AUTOS $ $ C X UMBRELLA LWI H OCCUR CUP3196T698 OS/29/11 OS/29/12 EACH OCCURRENCE $ 5,000,000 - 5,000,000 EXCESS UAS CLAIMS-MADE AGGREGATE $ I- PEDUCT1BLE $ RETENTION $ 10,000 , WORKERS COMPENSATION I ~';R~~~~S I I ~'!' $ AND EMPLOYERS' LIABILITY '" ANY PROPRIETORIPARTNERlEXECUTtVE [J E.l. EACH ACCIDENT $ OFF1CERlMEMSER EXCLUDED? "A (M.ndatarylnNH) E.L. DISEASE-EA EMPLOYEE $ lIyea,dllOl(:libeunder E.l. DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below $ A Professional Uabilily: Claims Made FOnTI 105320158 07/26/10 07/26/11 $1,000,000 Per Claim $1,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach ACORD 101, Additional Remam Schedule, If more space is required) Project: Water Street Bridge Project CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520-1814 AlITHORIZEO REPRESENTATIVE Attention: ~Shle:r. Hul~ ACORD 25 (2009/09) @1988-2009ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD , .i- Marquess & Associates Inc Policy #6806146N63A COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or 'personal injury" caused, in whole or in part. by your acts or omis- sions or the acts or omissions -of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products-completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which cover- age as an additional insured specifically is added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any' "professional services" . f. The limrts of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional Insured, or the limits shown in the Declara- tions for this Coverage Part. whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF CG 03 81 09 07 INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for . which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance". But this insur~ ance still is excess over valid and collectible other insurance, whether primary, excess. contingent or on any other basis, that is available to the insured when the insured is an addrtional insured under any of her insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", 'property damage" or "personal injury" arising out of "your work" performed by you. or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with such person or organization entered into by you before, and in effect when, the "bodily e 2007 The Travelers Companles. Inc. . Includes the copyrighted material of Insurance Services Office. Inc., With its pennission. Page 1 of 2 .;.:>. COMMERICAL GENERAL LIABILITY . injury" or Hproperty damage" occurs. or the "per- .sonal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): . . . "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to indude a person or organization as an additional insured on this qov. Page 2 of 2 ,. -. erage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal in- jury" is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. '.' . " 02007 The Travelers Companies. Inc. Includes the copyrighted material of Insurance Services Office, Inc., with its permission. CG 03 81 09 07 . ~ ~(; . COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the foliowing: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorse- ment, the provisions of the Coverage Form apply unless modified by the endorsement. A. PERSONAL EFFECTS COVERAGE SECTION III - PHYSICAL DAMAGE COVER. AGE, A. Coverage, 4. Coverage .Extensions is amended by adding the foliowing: Personal Effects Coverage We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) owned by an "insured"; and . . (2) in or on your coyered "aut?"; ,,- in the event of a total theft "loss" of your covered "auto", No deductibles apply to Personal Effects Cover- age. B. AUTO LOAN LEASE GAP COVERAGE SECTION III - PHYSICAL DAMAGE COVER. AGE, A. Coverage, 4. Coverage Extensions is amended by adding the foliowing: Auto Loan' Lease Gap Coverage for Private Passenger Type Vehicles In the event of a total "loss" to a covered "auto" of the private passenger type shown in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay any unpaid amount due on the lease or loan for such covered "auto" less the foliowing: (1) The amount paid under the Physical Damage '. Coverage Section of the policy. for that "auto"; and (2) Any: (a) Overdue lease/loan payments at the time of the "loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not retumed by the les- sor; CA T4 20 07 06 (d) Costs for extended warranties, Credit Life Insurance, Health, Acddent or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. C. COVERAGE EXTENSION - AUDIO,VlSUAL AND DATA ELECTRONIC EQUIPMENT NOT DESIGNED SOLELY FOR THE PRODUCTION OF SOUND SECTION III - PHYSICAL DAMAGE COVER. AGE, B. Exclusions, exception paragraph a. to exclusions 4.c & 4.d is deleted and replaced with the foliowing: a. Equipment and accessories used with such equipment, except tapes, records or discs, provided such equipment is permanently in- stalied in the covered "auto" at the time of the "loss" or is removable from a housing unit which is permanently instalied in the covered "auto" at the time of the "loss". and such equipment is designed to be solely operated by use of the power from the "auto's" electri- cal system, in or upon the covered "auto"; or D. WAIVER OF DEDUCTIBLE - GLASS SECTION III - PHYSICAL DAMAGE COVER. AGE, D. Deductible is amended by adding the foliowing: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. E. HIRED AUTO PHYSICAL DAMAGE COVER- AGE SECTION III - PHYSICAL DAMAGE COVER- AGE, A. Coverage, 4. Coverage Extensions is amended by adding the foliowing: Hired Auto Physical Damage Coverage Exten- sion If hired "autos" are covered "autos" for Liability Coverage and this policy also provides Physical Damage Coverage for an owned "auto". then the Includes the copyrighted material of Insurance Services Office, Inc. with its permission. Includes the copyrighted material of The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL AUTO Physical Damage Coverage is extended to "autos" that you hire, rent or borrow subject to the following: (1) The most we will pay for "loss" in anyone "accident". to a hired, rented or borrowed "auto" is the lesser of: (a) $50,000; (b) The actual cash value of the dam- aged or stolen property as of the time of the "loss"; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for deprecialjon . and physical condition will be made in deter- mining actual cash value in the event of a total "loss". (3) If a repair or replacement results in better than like kind or quaiity, we will not pay for the amount of betterment (4) A deductible equal to the highest Physical Damage deductible applicable to any owned covered "auto". (5) This Coverage Extension does not appiy to: (a) Any "auto" that is hired, rented or bor- rowed with a driver; or (b) Any "auto" that is hired, rented or bor- rowed from your "employee". F. BLANKET WAIVER OF SUBROGATION SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us is deleted and repiaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us . . '. We waive any right of recovery we may have against any person or organization to the ex- Page 2 of 2 ------- '. ~ tent required of you by a written contract exe- cuted prior to any "accident" or "loss", pro- vided that the "accident" or "loss" arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. G. BLANKET ADDITIONAL INSURED SECTION 11- LIABILITY COVERAGE, part A. 1. Who Is An Insured, paragraph c. is amended by adding the following: Any person or organization that you are required to include as an additional insured on this Cover- age Form in a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period is an "insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. H. EMPLOYEE HIRED AUTOS SECTION II - LIABILITY COVERAGE, A. COy. erage, 1. Who Is An Insured is amended by add- ing the following: An "employee" of yours is an "insured" while op- erating an "auto' hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. I. COVERAGE EXTENSION - TRAILERS SECTION I - COVERED AUTOS, C. Certain Trailers, Mobile Equipment and Temporary Substitute Autos, paragraph 1. is deleted and replaced by the following: 1. "Trailers" with a load capacity of 3.000 pounds or less designed primarily for travel on public roads. Indudes the copyrighted material of Insurance SelVices Office, Inc. with its permission. Includes the copyrighted material of The 51. Paul Travelers Companies, Inc. CA T4 20 07 06 ""f.".';'! .-~ , UMBRELLA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE The following is added to Paragraph 11., OUR RIGHT TO RECOVER FROM OTHERS., of SECTION IV - CONDITIONS.: . a. "Bodily injury" or "property damage" caused by an "occurrence" that takes place; or b. "Personal injury" or "advertising injury" caused by an "offense" that is committed; subsequent to the execution of the contract or agree- ment. "h_. _...... ". ......... _.... If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization. we waive our right of recovery against such person or organization, but only for payments we make because of: UM 04 88 07 08 @ 2008 The T raveJers Companies, tnc. Includes the copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1