HomeMy WebLinkAboutInternational Line BuildersA� o® CERTIFICATE OF LIABILITY INSURANCE
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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 have ADDITIONAL INSURED provisions or 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
MARSH USA LLC
333 South 7th Street, Suite 1400
CONTACT
Marsh I U.S Operations
PHONE 866 gfi6 4664 FAX,
Nn : 212-948.5382
ADoRIE , MDU.CeNRequest@marsh.com
Minneapolis MN 55402.2400
INSURERS AFFORDING COVERAGE
NAIC p
INSURER A. Liberty Mutual Fire Ins Co
23035
CH102299309-INTT•GAWX-24-25
INSURED International lane Builders, Inc.
INSURER B: Associated Electric & Gas Ins Services Lld
3190004
INSURER C - ibedy Insurance Corporation
42404
19022 WSW Cipole Road
Tualatin, OR 97062
INSURER 0
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: CHI-010467968-04 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,
INTR
TYPE OF INSURANCE
ADPL
SUER
POLICY NUMBER
MWDDYEFF NYYY
MWDDIYYXYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FX I OCCUR
TB2.641-445905-324
01101/2024
OW112025
EACH OCCURRENCE
S 2,000.000
DAMAGE TO RITEI
PREMISES EaEoccurrence
S 1,000,000
MED EXP (Any,one person)
S 10,000
PERSONAL & ADV INJURY
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECOT- LOC
GENERAL AGGREGATE
5 4,000.000
PRODUCTS-COMPIOP AGG
S 4,000.000
$
OTHER:
A
AUTOMOBILE
LIABILITY
A 2-641-005097-054
0141112024
01101I2025
GOMBINEb SINGLE LIMIT
Ea acci nt
$ 2,000,000
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOSHIRED
IR
BODILY INJURY (Per aoddenl)
S
PROPERTY DAMAGE
Per accitlenl
$
X NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAB
OCCUR
XL5063413P
01p1I2024
0110112025
EACH OCCURRENCE
$ 5,000,000
X
AGGREGATE
$ 5,000,000
EXCESS LIAB
CLAIMS -MADE
DEO RETENTIONS
S
C
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OFFCEORIMEMB REXCLUDED?ECUTIVE rAj�
(Mandatory In NH)
NIA
WA7.64D-005097-024(Reguated)
wA7.64Q005097-014 AOS
( '
"IncludeS'Stop-Gap "
IM112024
01A1n024
01,01025
01101n025
X PER OTH•
STATUTE ER
E.L. EACH ACCIDENT
$ 1,DO0,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
1T yes, describe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE -POLICY LIMIT
$ 1,000,OOD
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached It murs space is required)
Re: All Projects
City of Caldwell icJare included as additional insured under general liability per the attached CG 2010 and CG 2D37 endorsements and does not include professional liability coverage Blanket Additional Insured for
Automobile Liability is included per attached designated insured Endorsement CA 20 48. Excess liability applies io general liability, products and completed operations, automobile liability, and employers liability.
City of Caldwel tare included as Additional Insured per coverage form 8100 attached with regard to Excess Liability
City of Caldwell
621 Cleveland Blvd
Caldwell, ID 83605
LeS,liLeL�R1S_l�ie1�
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
of Marsh USA LLC
Q 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD