HomeMy WebLinkAboutInsurance Certificate: JACO Environmental Inc
Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MMA)D/YYYY)
111 09/20/2013
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 CONTACT
NAME:
Applied Rink Services, Inc. (AH/CO,N.,E.t): (877)234-4420 (A/XC,N.): (877)234-4421
10825 Old Mill Rd E-MAIL
Casaba, NE 681554 ADDRESS:
PRODUCER
(877)234-4420 CUSTOMER ID If
INSURER(S) AFFORDING COVERAGE NAIC 0
INSURED INSURER A: California Insurance Co. 38865
JACO Envirc¢mental, Inc. INSURER B:
dba Appliance Recycling Outlet INSURER C:
18323 Bothell Everett Hwy Ste 220
Bothell, VM 98012-5246 INSURER D:
INSURER E:
CTL 1273 781689 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO
WHICH THIS CERTIFICATE MAYBE 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 AD IL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR MD POLICY NUMBER MMND/YYYY MWDDNYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY ❑ ❑ DAMAGE TO RENTED $
CLAIMS PREMISES Esoccerrencel
7 -1
MADE OCCUR MED EXP An one son $
PERSONAL B ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG $
POLICY 71PROJECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANYAUTO ❑ ❑ (Ea ao ,,n $
ALL OWNED AUTOS BODILY INJURY Per no $
SCHEOULEDAUTOS BODILY INJURY Per ari ru $
HIRED AUTOS PROPERTY DAMAGE
Pere ident $
NON-OWNED AUTOS $
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CI-AIMS-MADE ❑ ❑ AGGREGATE $
DEDUCTIBLE'" . $
RETENTION $ r - $
WORKERS COMPENSATION - WC STATU- OTH-
AND EMPLOYERS' LIABILITY ryfyyyy,,,/N R T
EXECUTIVEO fl ERNEM ER aYI N/A 73-877317-01-01 09/15/2013 nOllcl2014 E.L. EACH ACCIDENT $ 11000,000
A
EXCLUDED? LJ 1,000,OOO
(Mandatory In NEB EL DISEASE-EAEMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.. L. . DISEASE-POLIDY Liu, 1,000,000
$
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, If more apace Is required)
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
90 N. Mountain AVOM1e EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
Ashland, 97520 THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE ~
Attn: rGm_ =~i TM+ Representative - 8 115 39
ACORD 25(2009M) The ACORD name and logo are reglatered marks of ACORD ®1988-2009 ACORD CORPORATION. All rights marred.