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HomeMy WebLinkAboutInsurance Certificate: Polydyne Inc (2) ^ CITY RECD^?ER FA IMM/IDD"-Y1 aC49R4 CERTIFICATE OF LIABILITY INSURANCE 1 2/31/2013 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_THEPOLICIES _ BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE.ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ' - - - - - oT:. _ rr I _ L: CL IMPORTANT:rIf the certiffcate. 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 Phone No.: (212)48&0200 CONTACT NME: Fax No.: (212) 488-0220 IAC,NAFAt Wcwt Frenkel & Company - AEAIAIL DDRESS. Toase Oe 350 Hudson Street - 4D' Floor VVKUDULhK New York, NY 10014 INSURER(5)AFFORDING COVEMEE HAICA INSURED wSURERA: Chants Specialty Insurance Company 26883 Polydyne Inc. INSURER B: Commerce & Industry Insurance Company 19410 One Chemical Plant Road INSURERC: Hartford Insurance Company of the Midwest 37478 PO BOX 250 INSURER D: National Union Fire Insurance Company of Pittsburgh PA 19445 Riceboro GA 31323 INSURERS 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 TYPEOFINSURANCE ~ SWUBIR POLICY NUMBER POLICY EFF POUCYEXP LIMITS LTR A GENERAL LIABILITY X EG14362834 12/3112013 12/31/2014 _ EACH OCCURRENCE 1,000,000 X' DAMAGE TO RENTED GMMERCIAL GENERAL' LIABILITYC ES Ea occurrence' $ 500,000 CLAIMS MADE OCCUR MED EXP (Any one person) $ 10,000 age e. t --,r; . 1 IH. y t _ 1 c.'^• .PERSONAL & ADV. INJURY „ 1',000,000 ' ' I r GENERAL AGGREGATE' 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER r 1 ' PRODUCTS COMP/OP-AGO $ 2,000,000 PRO- POLICY JECT LOC $ B AUTOMOBILE LIABILITY X CA4691818 12/3112013 12/31/2014 COMBINEDlSINGLE LIMIT $ 1,000,000 (Ee ealaen X ANYAUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS SCHEDULED AUTOS PROPERTY DAMAGE X NON-OWNED (Per aeddent) $ AUTOS $ D X uNSlmuueB X occuR X 13273528 12131/2013 12131l2014 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MODE AGGREGATE $ 1,000,000 DED RETENTION $ $ C WORKERS COMPENSATION 1OWNR30600 12131/2013 12/31/2014 X TORY LIMITS ER ANYANDEMPLOYERSPLUMBILrY ARTNER EXECIJTNE YIN E1 . EACH ACCIDENT $ 1,000,000 OFFICERIM CEWMEMBERMBEft EXCLUDED? ❑ N/A IMarchlayln NlQ E.L. DISEASE-EA EMPLOYEE $ 1,000,000 Xleedescrlbe under E.L. DISEASE POLICY LIMIT $ 1,000,000 -DESCRIPTION OF QPERAIIQNS 1XIm DESCRWrpN OF OPEMTpNS I LOCATN1N5l VEMOLEa (Aldcl, ADORD 101, Atlditbnal RameAP SGNtlub, rmw. epex 6 reWFed) City of Ashland is included as Additional Insured under General Liability, Automobile Liability and Excess/Umbrella Liability coverage as required by contract with respect to liability arising out of the operations of the Named Insured, as their interest may appear, and subject to the policy terms conditions and exclusions. Coverage applies on a primary and noncontributory basis as required by contract and subject to the policy terms Conditions and exclusions. RE: Polymer - Cladfloc C-6286 45 DAY CANCELLATION CLAUSE INCLUDED 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 90 N. Mountain Avenue ACCORDANCE WITH THE POLICY PROVISIONS Ashland, OR 97420 A ORIZED REPRESENTA VE 1 © 1988- 10 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ;ACORD