HomeMy WebLinkAboutInsurance Certificate: UNAVCO Inc P3M 2NU2
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A~ D® CERTIFICATE OF LIABILITY INSURANCE 11/15/2013
5/]013
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 u,
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. p
IMPORTANT: H the "dificats holder Is an ADDITIONAL INSURED, the policy(has) must be endorsed. H SUBROGATION IS WANED, subject to c2
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 Ilau of such andorseme s .
PRODUCER 1-303-773-9999 CONTACT Melissa Sapp-Birdwblstell v
Arthur J. Gallagher Risk Nanagemant Services, Inc. NAME' FAx e
MNE. .303-889-2544 No: >
6399 S. Fiddlers Oreen Cir CRESS: wllssa_sapp-birdwhlstellgajg.com z'
W
Suite 200
Y,) Greenwood Village, CO 80111 INSURER(S) MFOROING COVERAGE NMI
INSURERA: FEDERAL nul CO 20281
INSURED INSURERS:
UHAVCO Inc.
INSURER C :
6350 Nautilus Drive INSURER O:
Boulder, CO 80301 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 36954803 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.
Im TYPEOFINSURANCE JUDDL NMI POLICY NUMBER POLICY O EFF M gon,vvvi LIMrrs AVa A GENERAL UAeem 3598-8128 11/01/1 11/01/14 EACH OCCURRENCE $ 1,000,000
i COMMERCIALGENERAL l1ABILITY PREEMMI ET R NW ~ $1.000,000
CLAMS-MADE 1XI OCCUR MED E% M one pavan f 5,000
PERSONAL S ADV INJURY f 1,000,000
GENERAL AGGREGATE $2,000,000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPNPAGG f 21000,000
Z POLICY PR0. LDC f
JECT
A AUTONOINLE LIABILITY 7358-1997 11/01/V 11/01/14 COMBINED SINGLE LIMIT
ePai I) 3 1,000,000
Z ANY AUTO BODILY INJURY (PIN Pmaan) I
AlO w SCHEDULED BODILY INJURY (PIN accMnl) i
AUTOS AUTOS
HIREDAUTOS AUTOS IPw
f
A Z UNSNELLALA9 N OCCUR 7988-78-38 11/01/1 11/01/14 EACHOCCURRENCE $ 2,000,000
EXCESSLAB CLAIMS-MADE AGGREGATE $2,000,000
pEp RETENTION $
WORKERS COMPENSATION WC5TATU- OTH-
LIN ANDENPLOYERFLAINLDY YIN
ANY PROPRIEfOWPARTNEfLEXECUIIVE L1 NIA E.L. EACH ACCIDENT $
WICERIMEMSER EXCLUDED?
(NIN-aluyb NH) E.L. DISEASE - EA EMPLOYEE $
da~
DESCRIPTION OF OPERATIONS Oabw EL. DISEASE. POLICY LIMIT I
DESCRIPTIONOFOP TIONSILOCATIONS/YEIIKIES OMISN AfARD 101, A00Nbnvl ROnu,Xr 8P0vauM,Nmoe opa M,puhv0l
Re: GPS site P370 (Ashland Municipal Airport). The City of Ashland, Oregon an Oregon Municipal Corp. is included as
Additional Insured en the General Liability Policy if required by written contract or agreement subject to the policy
terms and conditions .
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland, Oregon an Oregon Municipal Corp. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Dawn Lamb -
20 B. Main Street AUTHORIZED REPRESENTATIVE
Ashland, OR 97520 USA Gat
® 798&2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
gmaehdan
36954803
P52W)2 2
Arthur J. Gallagher Risk 8lanagemeut Services, Inc. -
6399 S. Fiddlers Green Cir
Suite 200
Greenwood Village, CO 80111
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Electronic Service Requested EBIX BPO LL
O
5-DIGIT 97520
4461 0.5234 AV 0.357
IIlr~rrr~11~III~rIuI:~IIuJ~~'~~II~Ir~llrlllr~tll6~~6u~1~~11
City of Ashland, Oregon an Ib p
Oreggon Municipal C Z
20 E. MAIN STREET w
ASHLAND, OR 97520-1814
This document was brought to you by CertificateeRow and Arthur J. Gallagher Risk lranageaent
Services, Inc. in Greenwood Village, CO.-
Any documents forwarded with the certificate request were reviewed for the sole purpose of
-completing the certificate.-
If you have questions regarding the content of this document, please contact -
the Producer/Agent listed on the certificate of insurance.-
The data included in this notice and in the attached document is confidential to -
Rbix and Arthur J. Gallagher Risk Management Services, Inc.- _
cc:
The data included in this notice and in the attached document is confidential to Ebix BPO
and the party responsible for bringing you this information.
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