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HomeMy WebLinkAboutInsurance Certificate: Engineered Monitoring Solutions CERTIFICATE OF LIABILITY INSURANCE ~2/4/202Y) 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 endorsement(s). PRODUCER CONTACT Dee Hughes NAME, Slater S Associates-Insurance, Inc. PHONEF.B. (503) 624-0466 FAX (503)624-0846 Note PO Box 1469 E'MaL ,ss.dee@slaterinsurance.com Tualatin, OR 97062-1469 INSURERS AFFORDING COVERAGE NAIC0 INSURERA:SAIF CO 6196 INSURED INSURER B: Engineered Monitoring Solutions LLC INSURER C: 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. ILTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER iMMIDP[YYYYJ POLICY EFF POLICY UP LIMITS lum Jim GENERALUABILITY EACH OCCURRENCE E COMMERCIAL GENERAL LIABILITY PREMISES a oco n mce f CLAIMS.MADE ❑ OCCUR MED UP An one arson E PERSONAL S ADV INJURY E GENERAL AGGREGATE E GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG E 17 POLICY PRO- LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT fEa e0O6 n ANY AUTO BODILY INJURY (Per person) E ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) E NON-OWNED PROPERTY DAMAGE E HIRED AUTOS AUTOS (Per acciden f UMBRELLA UAB OCCUR EACH OCCURRENCE E EXCESS UAB CLAIMS-MADE AGGREGATE E DED RETENTIONS E A WORKERS COMPENSATION X. WC $TATD- DTH- AND EMPLOYERS'UABIUTY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L. EACH ACCIDENT E 1,000,000 OFFICER/MEMBER EXCLUDED? 958900 12/1/2012 12/1/2013 (Mandatory in NH) E. L. DISEASE-EA EMPLOYE E 1 000 000 If yes, drawls under DESCRIPTION OF OPERATIONS Celm E. L. DISEASE-POLICY LIMIT E 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remams Schedule, If more 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 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)DI The ACORD name and loco are registered marks of ACORD Ace CERTIFICATE OF LIABILITY INSURANCE DATE (MM OD YYY) 12/0412012 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 endorsement(a). PRODUCER Phone: 503-365.7001 Fax: 503-36&7354 COerncr NAM SLATER 8 ASSOCIATES INSURANCE MID VALLEY GENERAL AGENCY LLC PXII%~. Ax Fa. 1503-624-0466Re. 1503.624-0846 4305 RIVER ROAD N E-MAIL (first name) @slaterinsurance.com _ KEIZER OR 97303 PRODUCER 18476 MER 10 Agenry Hai: 100159512 INSURER(S) AFFORDING COVERAGE NAICA INSURED INSURERA : SCOTTSDALE INSURANCE COMPANY 41297 ENGINEERED MONITORING SOLUTIONS LLC 617 N MAIN ST INSURER B NEWBERG OR 97132 INSURERC INSURERD: INSURER E INSURERF COVERAGES CERTIFICATE NUMBER: 54035 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, OLL E" MITq SHOWN MAY HAVE BEEN RF )Ljr.Fn BY PA n F.1 AIMS INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMBS UP SR AND MMDD MMIDD A GENERA` `AMDIY Y CPS1658974 12/03/12 12/03/13 EACH OCCURRENCE E 1,000,000 X COMMERCIAL GENERAL LIABILITY DAEMMISETO RENMO< E 100,000 CLAIMS-MADE 11L IOCCUR MED. EXP(My meeamon) E 5,000 PERSONAL It 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 PR0. LOC $ AUTOMOBILE CIABULDY COMBINED SINGLE LIMIT E (Ea accident) ANY AUTO BODILY INJURY (Per Person) E ALL OWNED AUTOS BODILY INJURY (Par accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS Per accident E NON-OWNED AUTOS E E UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE DEDUCTIBLE RETENTION E E WORKERS COMPENSATION N'DaTATU OTX AND EMPLOYERS' LIABILITY YIN TORY LIMITS E ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT OFFICERMEMBER EXCLUDED? NIA IWmelory In NH) E.L. DISEASE-EA EMPLOYEE nm..dx. U,Mer DESCRIPTION OF OPERATIONS Eehw E.L. DISEASE-POLICY LIMIT E DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remark. Schedule, If more apace Is required) CITY OF ASHLAND IS INCLUDED AS AN ADDITIONAL INSURED PER GLS-150s (07-06). CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 N MOUNTAIN AVE ACCORDANCE WITH THE POLICY PROVISIONS. ASHLAND OR 97520 AUTHORIZED REPRESENTATIVE Attention: MID VALLEY GENERAL AGENCY LLC ^ - er`man R DeiLssJ~- ACORD 25 (2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD J ENDORSEMENT J SCOTTSDALE INSURANCE COMPANYO NO. ATTACHED TO AND ENDORSEMENT EFFECME DATE FORMING A PART OF nI.Dt AM. STANDARD TIME) NAMEDINSURED AGENTNO. P,DUCY NUMBER ENGINEERED MONITORING SOLUTIONS LLC CPS1658974 12-03-12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to this endorsement, SECTION IV=WHO IS a. All work, including materials, parts or equip- AN INSURED is amended to include as an additional in- ment furnished in connection with such work, sured any person or organization whom you are required to on the project (other than service, mainte- add as an additional insured on this policy under a written nance or repairs) to be performed by or on contract, written agreement or written permit which must be: behalf of the additional insured(s) at the loca- a. Currently in effect or becoming effective during tion of the covered operations has been com- the term of the policy; and pleted; or b. Executed prior to the "bodily injury," 'property b. That portion of "your work" out of which the in- damage," or'personal and advertising injury" jury or damage arises has been put to its in- tended use by any person or organization The insurance provided to these additional insureds is lim- other than another contractor or subcontrac- ited as follows: for engaged in performing operations for a 1. That person or organization is an additional insured principal as a part of the same project. only with respect to liability for "bodily injury," 3. The limits of insurance applicable to the additional "property damage" or "personal and advertising insured are those specified in the written contract, injury" caused, in whole or in part, by: written agreement or written permit or in the Decla- rations for this policy, whichever is less. These lim- a. Your acts or omissions; or its of insurance are inclusive of, and not in addition b. The acts or omissions of those acting on your to, the Limits of Insurance shown in the Declara- behalf. tions for this policy. A person's or organization's status as an addi- 4. Coverage is not provided for "bodily injury," tional insured under this endorsement ends when "property damage," or "personal and advertising your operations for that additional insured are injury" arising out of the sole negligence of the completed. additional insured. 2. With respect to the insurance afforded to these 6. The insurance provided to the additional insured additional insureds, the following exclusions are does not apply to "bodily injury," "property damage," added to item 2. Exclusions of SECTION I- or "personal and advertising injury" arising out of COVERAGES: an architect's, engineer's or surveyor's rendering of or failure to render any professional services This insurance does not apply to "bodily injury," including: "property damage" or "personal and advertising injury" occurring after: Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc., 2004 GLS-150s (7-06) Page 1 of 2 a. The preparing, approving or failing to prepare written contract specifically requires that this insur- or approve maps, shop drawings, opinions, re- ance be primary. ports, surveys, field orders, change orders or drawings and specifications; and When this insurance is excess, we will have no du- ty under SECTION I--COVERAGES to defend the b. Supervisory, inspection, architectural or engi- additional insured against any "suit" if any other in- neering activities. surer has a duty to defend the additional insured against that "suit." If no other insurer defends, we 6. Any coverage provided hereunder will excess will undertake to do so, but we will be entitled to the over any other valid and collectible insurance avail- additional insured's rights against all those other able to the additional insured whether primary, ex- cess, contingent or on any other basis unless a insurers. U O IZED R ESkNTj P ~ DATE Includes copyrighted macenai oT ibu rropenies, inc., win its permission. Copyright, ISO Properties, Inc., 2004 GLS-150s (7-06) Page 2 of 2