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HomeMy WebLinkAboutInsurance Certificate: Engineered Monitoring Solutions CERTIFICATE OF LIABILITY INSURANCE DAE IYW°DW ) 1112912011 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 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 endoreement(s). PRODUCER Phone: 5033657001 Put:503-3657354 CONTACT SLATER 8 ASSOCIATES INSURANCE .E MID VALLEY GENERAL AGENCY LLC °A",D°NH Ce, 1503-624-0466 rz NP. 1503.624-0946 4305 RIVER ROAD N E'""'L 53: (first name)@slaterinsurence.com OR KEIZER OR 97303 PRODUCER CUSTOMER CVSTOMER IO: INSURERS AFFORDING COVERAGE NAICA INSURED INSURERA :SCOTTSDALE INSURANCE COMPANY 41297 ENGINEERED MONITORING SOLUTIONS LLC 617 N MAIN ST INSURERS NEWBERG OR 97132 INS2RC INSURER D: INSVRERE INSURER COVERAGES CERTIFICATE NUMBER: 50444 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 15 SUBJECT TO ALL THE TERMS, 'NSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY Err POLICY EXP LIMITS LTR R WVD MM,O MMmD A GENERAL LIABILITY CPS1104202 12103111 12103112 EACH OCCURRENCE E 1,000,000 X COMMERCIAL GENERAL LIABILITY PR MEET ESE wEance E 100,000 CLAIMS-MADE X (OCCUR MED.EXP(Anyone person) E 51000 PERSONAL B ADV INJURY E 1,000,000 GENERAL AGGREGATE E 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG E 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT E (Ee accident) ANY AUTO BODILY INJURY(PW person) E ALLOWNEDAUTOS BODILY INJURY(Per socidanq E SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS Per accident) E NON-OWNED AUTOS E E UMBRELLA LUB OCCUR EACH OCCURRENCE S LESS LMS CIAIMS-MADE AGGREGATE DEDUCTIBLE RETENTION S E WORKS" COMPENBATRI WC STAT4 Me EMPLOYERS' LIABILITY YIN TORY IMITS DTM E My PROPRIETGRRARTNERMSIECUTNE E.L EACH ACCIDENT OFFICERnEMBER EXCLUDED? NIA Mand Cory In NMI E.L.DISEASE-EA EMPLOYEE 11',JasvlBS. DESCRIPTION OF OPERATIONS EWVx E.L.DISEASE-POLICY LIMIT E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarin Schedule,If mom space is required) CITY OF ASHLAND IS INCLUDED AS AN ADDITIONAL INSURED PER CG2010(07104). CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 90 N MOUNTAIN AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Attention: MID VALLEY GENERAL AGENCY LLC erman R Deiss�` ACORD 25(2009109) C 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,4coR°® CERTIFICATE OF LIABILITY INSURANCE DATE/29/2011 DD 111 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 endoreement(s). ' PRODUCER CONTACT Dee Hughes Slater S Associates Insurance, Inc. PHONE . (503)624-0466 FAX . (503)624-0846 (AID PO Box 1469 AEbmpAgLESS.dee@slaterinsurance.com INSURERS AFFORDING COVERAGE NAIC 0 Tualatin OR 97062-1469 INSURERA:SAIF CorP 36196 INSURED INSURER B: Engineered Monitoring Solutions LLC INSURERC: 617 N Main St INSURER D: Newberg, OR 97132 INSURER E: INSURER F: 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 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 ADDL SUBR POLICY EFF POLICY UP LTR TYPE OF INSURANCE POLICY NUMBER MMD LIMITS GENERALUABIUTY EACH OCCURRENCE f COMMERCIAL GENERAL LIABILITY PA T RENTE�n� f CLAIMS-MADE r_1 OCCUR MED EXP(Any one Person) E PERSONAL 6 ADV INJURY E GENERAL AGGREGATE E GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPMP AGO E POLICY PRO- LOC E RAUTOS MOBILE DASIU COMBINED SINGLE LIMIT de 1 NY AUTO BODILY INJURY(Per person) f LL OWNED SCHEDULED AUTOS BODILY INJURY(Per acadenU E IRED AUTOS AUTOS ED PROPERTY DAMAGE f S UMBRELLA LIAB OCCUR EACH OCCURRENCE E EXCESS LIAB CLAIMS-MADE AGGREGATE E DED I I RETENTIONS 1 S A WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER)EXECUTIVE❑ NIA E.L.EACHACCIDENT E 1000 000 OFFICERIMEMBER EXCLUDED? 958900 12/1/2011 12/1/2012 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE E 11000,00 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT f 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Addhional Remarks Schedule,N mom space Is required) CERTIFICATE HOLDER CANCELLATION (541)488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS. 90 N Mountain Ave - Ashland, OR 97520 AUTHORIZED REPRESENTATIVE / `- Dee Hughes/DMH ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS0 2 5 12010051 01 The ACORD name and l000 are registered marks of ACORD POLICY NUMBER: CPS1104202 COMMERCIAL GENERAL LIABILITY ENGINEERED MONITORING SOLUTIONS LLC CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - 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 Organization(s): Locations Of Covered Operations CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND OR 97520 POLICY PERIOD: 12-03-2011 TO 12-03-2012 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury", "property This insurance does not apply to 'bodily injury" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts e work, ment furnished in connection with such woork,, 2. The acts or omissions of those acting on your on the project(other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations has been completed; or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a prin- cipal as a part of the same project. CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑