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HomeMy WebLinkAboutInsurance Certificate: Rogue Waste Systems LLC CI ient#: 1137013 ROGUE WAS ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 09/19/2014 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: Teresa Weston USI Northwest PHONE 541 685-5300 FAX 866-968-4807 AIC No Ext : A/C No 975 Oak Street, Suite 900 E-MAIL ADDRESS: Eugene, OR 97401 541 685-5300 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Greenwich Insurance Company 22322 INSURED INSURER B: SAIF Corporation 36196 Rogue Waste Systems LLC PO Box 3187 INSURER C : XL Specialty Insurance Company 37885 INSURER Central Point, OR 97502 D: INSURER E 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 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. LIMITS LTRR TYPE OF INSURANCE NSR L WVD POLICY NUMBER MMLDDYIYYYy1' M/M DIDY EXP A GENERAL LIABILITY GE0003582703 1010112014 10/01/201 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREM SESo a j&E ante $100,000 CLAIMS-MADE FX]OCCUR MED EXP (Any one person) $5,000 X BI/PD Ded:1,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 POLICY PEA LOC $ C AUTOMOBILE LIABILITY AE0003582403 1010112014 10/01/201 CEaOMBINED SINGLE LIMIT accident 1, 000,000 X ANY AUTO BODILY INJURY (Par person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTYDAMAGE $ AUTOS Per acddent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION 519473 10/01/2014 10/01/201 X WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERJEXECUTIVE~ E 1. EACH ACCIDENT _ $1,000,000 OFFICER/MEMBEREXCLUDED? "I NIA - - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I 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 DESC tTI CANCELLE D BEFO THE EXPIRATION DATE THERE CE WILL BE DELIVERED 20 East Main St. ACCORDANCE WITH THE POLIC IONS. Ashland, OR 97502 S E P 3 0 2014 AUTHORIZED REPRESENTATIVE ! © 1988-2010 ACOR I s reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S13320588/M13320583 TRWJ R