Loading...
HomeMy WebLinkAboutInsurance Certificate: AccuSource (2) ACCUS-1 OF ID: AD CERTIFICATE OF LIABILITY INSURANCE 0 DATE 1 08128113 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 endorsement(s). PRODUCER 909.435-0230 NAME: CT Robbin McGinnis Sawyer Cook Insurance 1200 California St., Ste 260 909-798-7971 aco"N E111909-435-0237 - ac No: 909-798-7971 Redlands, CA 92374 - - ADDRESS: rmcginnis@sawyercook.com - ScottWilliamson INSURERS AFFORDING COVERAGE NAIC k INSURER A: Preferred Employers Insurance INSURED ACCUSOUrce INSURER B: Lianne Charton-Holder 1240 E. Ontario Ave #102 -140 NSURERC: Corona, CA 92881 INSURER D: 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 B TYPE OF INSURANCE Jb POLICY NUMBER POLICY /YYEFF YY POLICY LTR DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES Ea occvnenm $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ • GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC - - AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT Ea amidenl $ ANY AUTO - BODILY INJURY (Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident 8 UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DIED RETENTION $ $ WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ N/A WKN11788710 09/01/13 09101114 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S 1,000,00 If es, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Updated Workers Compensation.. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZ EPRE ENTATWE Scott liam n © 19811-2010 ACCORDCOORRPPO•'RATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD