HomeMy WebLinkAboutInsurance Certificate: Goseetell Networks A
CERTIFICATE OF LIABILITY INSURANCE 08-20.2012
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 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 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 certificate does not confer rights to the
certificate holder in lieu of such endorsementls).
PRODUCER C
KPD INSURANCE INC/PHS PHOI e FAX
700810 P: (866) 467-8730 F: (877) 905-0457 IAIC No E.0 (866) 467-8730 IAIC,Nel: (877) 905-045
PO BOX 33015 c ADDRESS:
SAN ANTONIO TX 78265 INSURERS)AFFORDING COVERAGE NAIC If
wsURERA : Hartford casualty Ins Co
INSURED INSURERS: Hartford Ins Co of the Midwest
GOSEETELL NETWORKS INC INSURER C:
3108 NW LURAY TER INSURER D
PORTLAND OR 97210 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.
LTq TYPE OF INSURANCE INSfl WVD POLICY NUMBER (MMIDD/YYYYI (MM/DD/YYVY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE 5 2, 000, 100
COMMERCIAL GENERAL LIABILITY PpEMISES IEe occurrence) $ 300, 000
A CLAIMS MADE xi l OCCUR �y� _ MED EXP(Any one person) $ 10, 000
X General Liab L`J H 52 SBM UR7842 07/15/2012 07/15/2013 PERSONAL&ADV INJURY Is 2 000, 000
GENERAL AGGREGATE I S 4 , 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 4 , 000, 000
POLICY u PECT A LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 2 , 000, 000
E.accident)
ANY AUTO _
BODILY INJURY(Per person) $
A ALL OWNED SCHEDU_L_ED u u 52 $Bh'L.UEZ7 fl42- _ 07/15/2012 07/15/2013 BODILY INJURY(Par accident) $
AUTOS u AUTOS
X HIRED AUTOS L AUTOS OWNED ... -.-- _ .. .. -. PROPERTY DAMAGE $
LX AUTOS (Per accident)
$
UMBRELLA LIAB u OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE I 'E] u AGGREGATE $
DEDI I RETENTION S I $
WORKERS COMPENSATION X WC STATU- OTH-
AND EMPLOYERS'LIABILITY VIN TORY LIMITS ER ANY B OFFICERIMEMB REXCLUDED7%ECUTIVEI NlA j 52 WEC FW1098 09/01/2012 09/01/2013 E.L EAC H ACCIDENT $ 5j0O 000
(Mandatary in NH) u LJ E.L.DISEASE -EA EMPLOYE 5500, 000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500, 000
uu
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Additional Remarks Schedule,if more space is imprinted)
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 SEP - 4 2012 DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
20 E MAIN ST AUTHORIZER R PRESENTATIVE /
ASHLAND, OR 97520aZ 71 C�Lr^��
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