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HomeMy WebLinkAboutInsurance Certificate: Rogue Waste Systems (2) 263583 ,a~oRV® CERTIFICATE OF LIABILITY INSURANCE 6 DATE (MWDDNYYY) 9/25/2013 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: PHONE FAX A/C No Wells Fargo Insurance Services USA, Inc E-MAIL ADDRESS: 975 Oak Street, Suite 900 INSURERS AFFORDING COVERAGE NAIC # Eugene, OR 97401 INSURER A: Greenwich Insurance Company 22322 INSURED INSURER B : XL Specialty Insurance Company 37885 Rogue Waste Systems, LLC INSURER C: SAIF Corporation 36196 PO Box 3187 INSURER D INSURER E : Central Point, OR 97502 INSURER F : COVERAGES CERTIFICATE NUMBER: 6615758 REVISION NUMBER: See below 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 TYPE OF INSURANCE INSR SUWVD ER POLICY NUMBER MM/DDY EFF MM/DDI Y LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A GE0003582702 10/1/2013 10/1/2014 DAMAGE TRENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE FKOCCUR MED EXP (Any one person) $ 5,000 X $1,000 BIRD Deduct. PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO- LOC $ B AUTOMOBILE LIABILITY AE0003582402 10/1/2013 10/1/2014 COMBINED SINGLE LIMIT 1,000,000 Ea accident) X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE Per accident $ HIRED AUTOS AUTOS TOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH C AND EMPLOYERS'LIABILITY YIN 519473 10/1/2013 10/1/2014 E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETORIPARTNEWEXECUTIVE ❑ NIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under 500,000 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) The City of Ashland, Oregon and its elected officials, officers and employees are listed as additional insureds but only with respects to the services provided by Rogue Shred, LLC. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2O East Main St. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97502 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)