Loading...
HomeMy WebLinkAboutdoc02716920150806115404Client#: 835015 ALTAPLAN ACORDTA,. CERTIFICATE OF LIABILITY INSURANCE (MMIDD/YYYY) (MM/DD GATE 6/26/2015 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 policy(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 USI Northwest 700 NE Multnomah, Suite 1300 OR 97232 503 224-8390 CONTACT Karen Barry PHONE (A/C, No, Ext): 503 224-8390 'rim, No): 610 362-8130 E oaess: karen.barry@usi.biz APortland, INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED Alta Planning + Design, Inc. 711 SE Grand Avenue Portland, OR 97214 INSURER B : Travelers Property Casualty Ins 36161 Travelers Indemnity Com 25658 INSURER C : Y pan Y INSURER D : SAIF Corporation 36196 INSURER 5 Zurich American Ins. Co. 16535 INSURER F: Continental Casualty Company 20443 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 CONTRACTOR 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. INSR LTR TYPE OF INSURANCE ADDL /NSR SUBR MD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YVYY) (MM/DD/YYVY) LIMITS 07/01/2015 07/01/2016 EACH OCCURRENCE 52,000,000 A B B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 680813259484 6808B259331 07/01/2015 07/01/2016 PREMISES°aocaurence) 51,000,000 CLAIMS -MADE I X OCCUR MED EXP (Any one person) 510,000 PERSONAL & ADV INJURY 52,000,000 GENERAL AGGREGATE s4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JECOT- , LOC PRODUCTS - COMP/OP AGG 54,000,000 J$ AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED I AUTOS I _ X' HIRED AUTOS ' v _ _AUTOS SCHEDULED AUTOS NON -OWNED -- - ----- --- - BA7A574417 -- — — — - 07/01/2015 07/01/201d (EOa acciden SINGLE LIMIT _ 51,000,000 BODILY INJURY (Per person) 5 BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) s 5 C XI UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP8B259933 07/01/2015 07/01/2016 EACH OCCURRENCE x5,000,000 AGGREGATE x5,000,000 S DED I X RETENT ON SO D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) II yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 771940 8997892 WA Stop Gap - EL OH Stop Gap - EL MCH114135257 09/01/2014 09/01/2015 X IToRYTLIMITS 1 IERH 09/01/2014 09/01/2015 E.L. EACH ACCIDENT 51,000,000 included E.L. DISEASE - EA EMPLOYEE 51,000,000 included 07/01/2015 07/01/2016111 E.L. DISEASE - POLICY LIMIT $3,000,000 Per Claim $4,000,000 Aggregate 51,000,000 F Professional Liability DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Projects as on file with the insured including but not limited to Share the Path Program. City of Tiburon is named as additional insured on general liability policy as required by written contract or agreement per attached endorsement CGD3810907. CERTIFICATE HOLDER CANCELLATION City of Tiburon Attn: Diane Crane lacopi 1505 Tiburon Blvd. Tiburon, CA 94920 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S15664392/M15662847 KDMZP This page has been left blank intentionally: POLICY NUMBER: 680 -8B259331 - POLICY NUMBER: 680-8B259484. COMMERCIAL 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 ll): 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 limits 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 CGD3810907 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 additional insured under any other 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 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission COMMERCIAL GENERAL LIABILITY injury" or "property 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 include a person or organization as an additional insured on this Cov- 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. © 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission