HomeMy WebLinkAboutInsurance Certificate: Goseetell Networks Inc �p
AC�A1 DATE IMMIDDIYYVYI
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CERTIFICATE OF LIABILITY INSURANCE 07-31-2012
THIS CERTIFICATEIS 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 CERTIFICATEOF 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 ADDITIONALINSURED,the policy(ies)must be endorsed. If SUBROGATIONIS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statementon this certificatedoes not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER ON T
ON
KPD INSURANCE INC/PHS (AiC"No F.0 (866) 467-8730 IA/C,NoI: (877) 905-045
700810 P: (866) 467-8730 F: (877) 905-0457
PO BOX 33015 ADDRESS:
SAN ANTONIO TX 78265 INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A : Hartford Casualty Ins Co
INSURED INSURER B
INSURER C
GOSEETELL NETWORKS INC INSURER D:
3108 NW LURAY TER
INSURER E
PORTLAND OR 97210
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.el INSR rypE OF INSURANCE POLICY NUMBER (MMIDDIYVYYI (MMIDDIYYYV)
LIMITS
LTfl 1NSR WVD
GENERAL LIABILITY EACH OCCURRENCE 5 2, 000, 000
COMMERCIAL GENERAL AL LIABILITY PREMISES IEa occurrence) S 300, OOO
A CLAIMS-MADE °' OCCUR MET EXP(Any one person) $ 10, 000
X General Liab U u 52 SBM UR7842 07/15/2 012 07/15/2013 PERSONAL&ADV INJURY S 2 , 000, 000
GENERAL AGGREGATE S 4 , 000, 000
GEN'L L°J
AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG 5 4 , 000, 000
Li POLICY L JECT LOG $
AUTOMOBILE LIABILITY -'- '- - -' "'-" 'COMBINED SINGLE LIMIT 5 2, 060, 000
IEa accident)
ANY AUTO
BODILY INJURY(Per person) $
I I
A ALL OWNED SCHEDULED .0 a 52 SBM UR7842 07,/15/2012 07/15/2013 BODILY INJURY IPer accident) 5 -
AUTOS I AUTOS
X HIRED AUTOS X NON OWNED PROPERTY DAMAGE $
(Par xcidenq
AUTOS
5
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS UAB u CLAIMS-MADE u u AGGREGATE $
DED I RETENTION $ 1 $
WORKERS COMPENSATION I WC STATU- OTH-
AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER
ANY PROPRIETORIPARTNER/EXECUTIVEI 1 NSA E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? u
(Mandatory in NH) E.L. DISEASE-EA EMPLOYE S
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5
uu
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
Those usual to the Insured' s Operations . City of Ashland is an Additional
Insured per the Business Liability Coverage Form SS0008 .
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
City of Ashland DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
20 E MAIN ST AUTHORIZE-0 UPRESENTATIVE
ASHLAND, OR 97520
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