HomeMy WebLinkAboutInsurance Certificate: Thomas V Murphy LLC OP ID: TMF
CERTIFICATE OF LIABILITY INSURANCE °"061/20/11 20111 0 "
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 WANED, subject to
the terms and conditions of lhe,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 c
PRODUCER 541-7735358 AM Karoline I ou
Protectors Insurance, LLC .PHONE
Pilot Rock Ins Agency LLC (CA) 541-772-190 °No E :541-773-5359 No: 541-772-1906
PO Box.4669 karoll p rotectorsins.COm
Memord, OR 97901 .MURPH-2
Karol M.Igou
INSURERS)AFFORDING COVERAGE NAICi
INSURED Thomas V Murphy LLC SJSURERA:Kinsale Insurance Company
755 Capella Cir INSURERB:Travelers Cas Ins CO ofAmerica
Ashland,OR 97520, iNsuaERC:Darwin Select Insurance Co
INSURER F
INSURER D
INSURGRe:
COVERAGES CERTIFICATE NUMBER:' SIO NU
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.POUI INSR TYPE OF INSURANCE POLICY NUMBER M POLICY X LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
A X COMMERCIALGENERALEIABILITY X. 01000022040-0 05119/11 05M 9112 PREMISES Ea occurrence $ 100,00
CLAIMSMADE OCCUR. MED EXP(My one person) $ Exclude
PERSDNOL S ADV.INJURY $ 1,000,00
GENERAL AGGREGATE $ 2,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP ADS $ Exclude
Pni Iry PRO- r� $
AUTOMOBILE LIABILT/ X COMBINED SINGLE LIMIT $ 1,000,00
(Ea accident)
$ 1ANYAJfTo BA-1 A665181 o911 sri1 05M9/12 BODILY INJURY(Per person) $
ALL OWNED ALTOS BODILY NUJRY(Per accident) $
SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS (Per accil.ri $
NON-CMED AUTOS $
3
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAR -CLAMS-MADE AGGREGATE $
DEDUCTIDLE j
RETENTION It
WORKERS COMPENSATION W A
AND EMPLOYERS'LIABILITY YIN T
ANY PROPRIETORPARnJERIEXECUTIVE NIA❑ EL EACH ACCIDENT $
OFFICERIMEMEEREXCLLGED"!
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $
If yes,descr ee under
RIPTI N 1F A e E.L.DISEASE-POLICY LIMIT $
C Professional Liab X 030"785 05/19111 05119H2 Per Claim 1,000,00
Aggregate 1,00e,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attssh ACORD 101;AddI9onal Remsi Schedule,it more space is required)
Consulting Forester -
Q [E CEO I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland. THE EXPIRATION DATE THEREOF, NOTICE WILL.. BE DELIVERED IN
20 E Main Str ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland,OR 97520 ,JUN 22
AUTHORIZED REPRESENTATIVE
Karol M.Igou
OO 1980-2009 ACORD CORPORATION: All righta,reserved.
ACORD 25(2009/09) 1 Ins_ ame mand logo are registered marks of AC
tSfZY Q (1,nDER
l
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT
Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured
o51n/n 12:01AM at the Named Insured
0100002204-0 Thomas V Murphy LLC
address shown on the Declarations
Additional Premium: Return Premium:
$0.00 $0.00
This endorsement modes insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE
A. SECTION II-WHO IS AN INSURED is amended to include'any person or organization you are required to include as an
additional insured on this policy by written contract in effect during the policy period and executed prior to the
"occurrence"of the"bodily injury"or"property damage"but only for the vicarious liability imposed on the Additional
Insured provided that such liability is caused by the sole negligent conduct of the Named Insured and is proximately
caused by"your work'or"your product"for the Additional Insured.
B. The insurance provided to the Additional Insured under this endorsement is limited as follows:
1. In the event the written contract requires limits of insurance in excess of the Limits of Insurance provided
by this policy,the Limits of Insurance provided by this policy shall apply and not the limits required by the
written contract.This endorsement shall not increase the Limits of Insurance stated in the De_clarations of
this policy.
2. This insurance does not applyto"bodily injury"or"property damage"arising out of"your work"or"your
product"included in the"products-completed operations hazard"unless you are required to provide such
coverage by written contract. If such insurance is required by written contract, the insurance pruvided to
the Additional Insured is limited to the alleged or actual vicarious liability imposed on the Additional
Insured as a result of the alleged or actual negligent conduct of the Named Insured as a result of liability
solely caused by"your work'or"your product"for the Additional Insured.
3. Any insurance provided by this endorsement to an Additional Insured shall be excess over any other valid
and collectible insurance available to the Additional Insured whether primary,excess,contingent or on
any other basis unless a written contract specifically requires that this insurance apply on a primary or
primary and noncontributory basis.
4. Where there is no duty to defend the Named Insured,there is no duty to defend the Additional Insured.
Where there is no duty to indemnity the Named Insured,there is no duty to indemnity the Additional
Insured.
5. This insurance does not apply to"bodily injury"or"property damage,"arising out of the sole negligence of
the Additional Insured or any employees of the Additional Insured.
C. Duties of the Additional Insured in the event of"occurrence",claim or"suit":.
1. The Additional Insured rnusL prumplly give nulice of an "uca:unence",a ddllTI which is made ur a"suiL",
to any other insurer,which has insurance for a loss to which this insurance may apply.
2. The Additional Insured must promptly tender the defense of any claim made or"suit"to any other insurer
which also issued insurance to the Additional Insured as Named Insured or to which the Additional
Insured may qualify as an Additional Insured for aloss to which this insurance may apply.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
CAS5010 0110 Page 1 of 1
ENDORSEMENT NO.2
ADDITIONAL INSUREDS/CO-DEFENDANTS
This Endorsement, effective at 12:01 a.m. on 05/19/2011,forms part of
Policy No. 0306-0705
Issued to Thomas V Murphy LLC
Issued by Darwin Select Insurance Company
In consideration of the premium charged, it is hereby agreed that coverage under this Policy shall be
extended to include Claims against the following persons or entities:
City of Ashland
hereinafter referred to ac "Addifinnal Insureds", prnvidPd hnwPver,that any curb Claim: (1)is mach and
continuously maintained against at least one Insured, other than an Additional Insured, and(2)arises out
of Professional Services performed on behalf of the Named Insured or any Subsidiary; and otherwise
covered under this Policy.
The coverage provided by this Endorsement is excess of, and shall not contribute with, any other
applicable insurance plan, policy or program of self-insurance carried by or applicable to a person or
entity listed above.
All other terms, conditions and limitations of this Policy shall remain unchanged.
Authorized Representative
v1875 (3/2008)
' - - COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTO COVERAGE PLUS. ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorse- (d) Costs for extended warranties, Credit Life
ment, the provisions of the Coverage Form apply Insurance, Health, Accident or Disability
unless modified by the endorsement. Insurance purchased with the loan or
A. PERSONAL EFFECTS COVERAGE lease;and
SECTION III — PHYSICAL DAMAGE COVER- (s) Carry-over balances from previous loans
AGE; A. Coverage; 4. Coverage Extensions is or leases.
amended by adding the following: C. COVERAGE EXTENSION — AUDIO, VISUAL
Personal Effects Coverage AND DATA ELECTRONIC EQUIPMENT NOT
We will pay up to $400 for "loss" to weaning ap- DESIGNED SOLELY FOR THE PRODUCTION
OF SOUND
parel and other-personal effects which are:
SECTION III — PHYSICAL DAMAGE COVER-
(1) owned by an"insured"; and AGE, B. Exclusions, exception paragraph a. to
(2) in or on your covered "auto"; exclusions 4.c & 4A is deleted and replaced with
in the event of a total theft,"loss" of your covered the following:
"auto". a. Equipment and accessories used with such
No deductibles apply to Personal Effects Cover- equipment; except, tapes, records or discs,
ogc provided such equipment is permanently in-.
stalled in the covered "auto" at the time of the
B. AUTO LOAN LEASE GAP COVERAGE "loss" or is removable from a housing unit
SECTION III — PHYSICAL DAMAGE COVER- which is permanently installed in the covered
AGE, A. Coverage, 4. Coverage Extensions is "auto" at the time of the "loss", and such
amended by adding the following: equipment is designed to be solely operated
Auto Loan Lease Gap Coverage for Private by use of the power from the "auto's" electri-
Passenger Type Vehicles cal system, in or upon the covered"auto"; or
In the event of a total "loss"to a covered "auto"of D. WAIVER OF DEDUCTIBLE—GLASS
the private passenger type shown in the Schedule SECTION III PHYSICAL DAMAGE COVER-
or Declarations for which Physical Damage Cov- AGE, D; Deductible is amended by adding the
erage is provided, we will pay any unpaid amount following:
due on the lease or loan for such covered"auto" No deductible for a covered "auto" will apply to
less the following: glass damage if the glass is repaired rather than
(1) The amount paid under the Physical Damage replaced.
Coverage Section of the policy for that"auto", E. HIRED AUTO PHYSICAL DAMAGE COVER-
and AGE
(2) Any: SECTION III — PHYSICAL DAMAGE COVER-
(a) Overdue leaselloan payments at the time AGE, A. Coverage, 4. Coverage Extensions is
of the"loss amended by adding the following:
(b) Financial penalties. imposed under a Hired Auto Physical Damage Coverage Exten-
lease for excessive use, abnormal wear sion
and tear or high mileage; If hired °autos" are covered "autos" for Liability
(c) Security deposits not returned by the les- Coverage and this policy also provides Physical
sor, Damage Coverage for an owned "auto", then.the
CA T4'20 07 06 Includes the copyrighted material'of Insurance Services Office„Inc.with its permission. Page 1 of 2
'Includes the copyrighted matanel of The et Paul Travelers Companies,.Inc.
COMMERCIAL AUTO
Physical Damage Coverage is extended to tent required of you by a written.contmct exe-
"autos"that you hire, rent or borrow subject to the cuted prior to any "accident" or 'loss", pro-
following: vided that the "accident"or"loss"arises out of
(1). The most we will pay for"loss"in any one the operations contemplated by such con-
"accident" to a hired, rented or borrowed tract.The waiver applies only to the.person or
"auto" is the lesser of organization designated in such contract.
(a) $50,000; G. BLANKET ADDITIONAL INSURED
(b) The actual cash value of the dam- SECTION II— LIABILITY COVERAGE, part A. 1.
aged or stolen property as of the time Who Is An Insured, paragraph c. is amended by
of the"loss"; or adding the following:
(c) The cost of repairing or replacing the Any person or organization that you are,required
damaged or stolen property, with to include as an additional insured on this Cover-
otherpropeity of like kind and quality. age Form in a written contract or agreement that
is signed and executed by you before the "bodily
(2) An adjustment for depreciation and injury" or"property damage" occurs and that is in
physical condition.will be made in deter- effect, during the policy period is an "insured"for
raining actual cash.value in the event or a Liability Coverage, but only for damages to which
total "loss this insurance applies and only to the extent that
(3)' If a repair or replacement results in better person or organization qualifies as, an "insured"
than like kind or quality, we will not pay under the Who Is An Insured provision contained
for the amount of betterment. in.Section 11.
(4) A deductible equal to the highest Physical H. EMPLOYEE HIRED AUTOS
Damage deductible applicable to any SECTION 11 — LIABILITY COVERAGE,.A. Cov-
owned covered"auto". erage, 1. Who Is An Insured is amended by add-
(5). This Coverage Extension does not apply ing the following:
to: An "employee" of yours is an "insured" while op-
(a) Any"auto"that is hired, rented or bor- erating an "auto" hired or rented under, a contract
rowed with a driver, or or agreement in that "employee's" name', with
(b) Any"auto"that is hired, rented or bor- your permission, while performing duties related
rowed from your"employee". to the conduct of your business.
F. BLANKET WAIVER OF SUBROGATION 1. "COVERAGE,EXTENSION—TRAILERS
SECTION IV—BUSINESS AUTO CONDITIONS, SECTION 1 — COVERED AUTOS, C. Certain.
A. Loss Conditions, 5. Transfer Of Rights Of Trailers, Mobile Equipment and Temporary
Recovery Against Others To Us is deleted and Substitute Autos, paragraph 1. is deleted and
replaced by 1he`following: replaced by the following:
5. Transfer Of Rights Of Recovery Against 1. "Trailers" with a load capacity of 3,000
Others To Us pounds or less designed primarily for travel
We waive any right of recovery we may have on public roads:
against any person or organization to the ex-
Page 2 of 2. Includes the copyrighted material of Insurance services Office,Inc.with its permission. CA T4 20 07 06
lnclu}las the copyrighted matanslbf The St.Paul Travalars Companies,.Inc.