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HomeMy WebLinkAboutARTIC SLOPE REGIONAL CORPORATION - INSURANCE CERTIFICATE1 ADDITIONAL INSURED— DESIGNATED PERSONS OR ORGANIZATIONS Named Insured ARCTIC -SLOPE REGIONAL CORPORATION Endorsement Number Policy Symbol I Policy Number Policy Period Effective Date of Endorsement- ISA H08872429 06/01 /2020 06/01 /2021 Issued By (Name of Insurance Company) ACE American Insurance Company mvm, my yu"oy .un,uv,. ...r o,w.. ����� o�� �.�o��..,, v .. vw �......�.,.r...r........... ........ ,....,�. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following;. BUSINESS AUTO COVERAGE FORM. AUTO (DEALERS COVERAGE FORM , MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to..include.as_an-additior A. For a covered "auto," Who Is Insured jis amended to include as an "insured," the persons or organizations named in this endorsement. However, these persons or organizations are an "insured" only for "bodily injury" or "property damage" resultinglfrom acts or omissions of: 1. You. 2. Any of your "employees" or agen 3. Any person operating a covered B. The persons or organizations named DA-9U74c (03/16) to with. permission from you, any of your"employees" or agents: this endorsement are not liable,for payment of your premium. Authorized Representative Page,1 of 1 3 of 5 6755 POLICY NUMBER: HDO G71080080 001 .: Endorsement Number. COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED e OWNERS, LESSEES OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or nization s Locations Of Covered Operations Any person or organization whom you have agreed to All locations where you are performing ongoing include as an additional insured under a written operations for such additional insured pursuant to any contract, provided such contract was executed prior to such written contract. the date of loss: Information required to com lete this Schedule, if not shown above .will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal :and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the C. insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to Provide for such additional insured. This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work' out of which the injury or damage 'arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as apart of the same project. With respect to the insurance afforded to these additional insureds, the following is added to section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we CG 20 10 04 13 C Insurance Services Office, Inc., 2012 Pagel of 2 will pay on behalf of the additional amount of insurance: 1. Required by the contract or agre 2. Available under the applical Insurance shown in the Declarat red is the whichever is less. This endorsement shall not increase the it; or. applicable Limits of Insurance shown in the Limits of Declarations. Paget of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 4 of 5 675 POLICY NUMBER: HDO G71080080 001 Endorsement Number. COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This: endorsement modifies insurance provided under the following: COMMERCIAL. GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization whom you have agreed to All locations where you perform work for such additional include as an additional insured under a written insured pursuant to any such written contract. contract; provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" .or "property damage" caused, in whole or in part, by "your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured - " -. .. - --. - _. - - -1 " - .Endorsement Number ARCTIC SLOPE REGIONAL CORPORAT ION Policy Symbol Policy Number Policy Period I - - - 'Effective Date of Endorsement HDO G71080080 001 06/01/2020 to 06/01/2021 i Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy. number. The remainder of the information Is to be completed only when this endorsement is issued subsequent to the preparation of me policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY COVERAGE Schedule Organization Additional Insured Endorsement Any additional insured to whom you have agreed to provide such non-contributory.insurance, pursuantlo and as required under a written contract executed prior to the date of loss. (If no information is filled in, the through an en For organizations that are listed in the attached to this policy, the following is Ifotherinsurance is available to an above (the "Additional Insured") for on a primary basis and we will not Insured. LD-20287106/06) shall read: "All persons or entities added as additional insureds t with the term "Additional Insured" in.the title) ule above that are also an Additional Insured under an endorsement to Section IV.4.a: Insured we cover under any of the endorsements listed or described loss we cover under this policy, this insurance will apply to such loss leek contribution from the other insurance available to the Additional Authorized Agent Page 1 of 1 5 of 5 6755 Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number ARCTIC SLOPE REGIONAL CORPORATION 3900 C STREET SUITE 201 Policy Number ANCHORAGE AK 99503 Symbol: WLR Number: C48135298 Policy Period Effective Date of Endorsement 06-01-2020 TO woo -2021 06-01.2020 Issued By (Name of insurance Company) ACE AMERICAN INSURANCE COMPANY Insert.the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation ofahe Folic-Y. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule ANY PERSCN OR CRG(kNI ZATI ON AGAI NST NFICM YCU HAVE AGREED TO VAI VE YCUR R GHT CF RECOVERY I N A VWI TTEN OMTRACT, PRCVI DED SUCH OCINTRACT MS EXECUTED PRICR TO THE DATE OF LOSS. For the states of CA, UT, TX; refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications, According to Section 287.150(6) ofahe Missouri statutes, a contractual provision purporting to waive subrogation rights:against public policy and void Where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in. Private Construction Contract ACt(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/05) Ptd. U.S.A. Copyright 1982-83, National Council on.Compensation