HomeMy WebLinkAboutMcCormack Construction�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY)
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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(les) 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 CONTACT
Woodruff -Sawyer Oregon, Inc. ukw WS CertificatesPHONE FAx
5005 Meadows Road, Suite 415 IOr.C.NQ.W; 844-972-6326 tac,No):.
Lake Oswego OR 97035 ADDRESS: certifte_ates[dwoodruffsawyer.com
INSURER A! Illinois Union Insurance Company
INSURED MCCOCON'01 INSURER B , Hartford Fire Insurance Company
McCormack Construction Co.
1761 SW 32nd Place INSURER C ; Trumbull Insurance Company
Pendleton, OR 97801 INSURER D Hartford Casualty Insurance Com
COVERAGES CERTIFICATE NUMBER:21224R555r; Iaevlclf%M ulluneo.
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.
INSR ADOL BUBR POLICY EFF POLICY E%P
LTR TYPE OF INSURANCE POLICY NUMBER (MWDDNYYYi rMw ofyyyyi LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
Y
52UEABC7WSK
5712024
51rirM5
EACH OCCURRENCE
$1.000,000
$ 300 000
$ 10.000
GI.Gap SIM X OCCUR
WA Stopp Gap $1 M
DAMP.G�EO
PREIS MES iEarrzyrrenceL
MED EXP (Any one person)
X
PERSONAL BADV INJURY
$ 1,000,000
GENT
AGGREGATE LIMIT APPLIES PER:
POLICY � JECOT- LOC
GENERAL AGGREGATE
$ 2.000,000
PRODUCTS - GOMP70P AGG
$ 2,000.000
Cantraclual Liab.
$ Induded
OTHER
C
AUTOMOBILE LIABILITY
X ANY AUTO
52UEACG7569
5112024
5,117075
ECOMBINED
rnSINGLE-LIMIT
BODILY INJURY {Per personl
$1000000
S
OWNED SCHEDULED
AUTOS ONLY AUTOS
I$
BODILY INJURY (Per accident)
S
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Par accident
5
D
X
UMBRELLA LIAB
X
OCCUR
52RHABC7WX7
511/2024
Sf1+7325
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
EXCESS LIAR
CLAIMS -MADE
$ 10,000,000
DIED I X I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y 1 N
ANYPR OPR IETORiPAR THE Rf E X ECUT NE
OFFICEPJMEMBEREXCLUDED7 ❑
N 1 A
PER OTH-
STATUTE I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NHI
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
A
Pollution Liability
COOG27645653010
5/1/2024
V1=5
Per occufrewWAgg
$2,000,000
SIR
$25,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORO 101, Additional Remarks Schedule, may bo attached if more space is required)
Operations of the Named Insured subject to the terms, conditions and exclusions of the policy issued by the Insurance Company.
MAR 17 7025
See Attached...
NM19V CL .M 11VIY
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Caldwell ACCORDANCE WITH THE POLICY PROVISIONS.
Attn- Purchasing
P 0. Box 1179 AUTHORIZED REPRESENTATIVE
Caldwell, ID 83606
acr 6ltnR.,_.the..✓V
IV Tyas-1oT5 ACURV CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD