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Home My WebLink AboutInsurance Certificate: JACO Environmental Inc (2) A~ CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 Ui(24/2 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: Willis of Seattle, Inc. FAX c/o 26 Century Blvd. N ~ 877-945-7378 A/C 888-467-2378 . NO) P. O. Box 305191 E-DRIL certificates®willis.com Nashville, TN 37230-5191 INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA: Aspen Specialty Insurance Company 10717-001 INSURED SACO Environmental, Inc INSURER B: St. Paul Surplus Lines Insurance Co. 30481-000 . PO Box 14307 INSURERC: California Insurance Company 38865-001 Mill Creek, WA 98082 INSURERD: Continental Indemnity Company 28258-001 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 20433937 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 rypE OFINSUFUNCE DD' SUB POLICY NUMBER POLICY EFF POLICY UP LIMITS A GENERAL LIABILITY ERAAX1413 9/15/2013 9/15/2014 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY PREMSESOEe6.mnce $ 1,000,000 CLAIMS-MADE OCCUR MEDEXP(myoneperson) $ 5,000 X WA Stop Gap Included PERSONAL B ADV INJURY $ 2,000,000 X $10.000 Deductible GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X IRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANYAUTO BODILY INJURY(Pe,person) $ ALLOWNED SCHEDULED BOO ILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED J H $ AUTOS B X UMBRELLA LIAB X OCCUR ZUP14S7979813NF 9/15/2013 9/15/2014 EACH OCCURRENCE $ 51000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION 738773170101 9/15/2013 9/15/2014 X R AND EMPLOYERS' LIABILITY YIN D ANY PROPRIETORIPARTNEWEXECUTNE N/A 738773170102 9/15/2013 9/15/2014 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (MLndmory in NH) E.L. DISEASE - EA EMPLOYEE $ 11000,000 ffff yas, tlescribe antler DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A ERAAK1413 9/15/2013 9/15/2014 Pollution Legal Liability $2,000,000 Per incident including BI/PD a Cleanup $2,000,000 Aggregate Policy # ERAAK1413 $ 25,000 Deductible Each Incident DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ANech Acord 101, Additonal Remarks Schedule, H more space Is required) Workers Compensation Policy #73-877317-01-01: Covers the following states: Covers: AZ, CA, GA, NV, OR, TX, UT. Workers Compensation Policy #73-877317-01-02: Covers the following states: IL, IN, ND, MI, MN, NC, NJ, NM, PA. The Umbrella policy also extends over the primary Auto Liability policy which has a $2,000,000 limit. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE Attn: Purchasing Representative 90 N. Mountain Avenue Ashland, OR 97520 Coll:4218969 Tpl:1703390 Cert:20433937 ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: JAC088 LOC#: A~ ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMEDINSURED JACO Environmental, Inc. Willis of Seattle, Inc. PO Box 14307 POLICY NUMBER Mill Creek, WA 98082 See First Page CARRIER NAIC CODE See First Page EFFECnVEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Excess Pollution Legal Liability Policy # EXAD93M13 Effective Date: 09/15/2013 Expiration Date: 09/15/2014 Insurance Carrier: Aspen Specialty Insurance Company Limits: $3,000,000 ACORD 101(2008/01) Coll:4218969 Tpl:1703390 Cert:20433937 ®2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD