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HomeMy WebLinkAboutInsurance Certificate: VSS Emultech BASIC-1 OP ID: JV ACOR~' r ATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 03/0412015 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). CONTACT PRODUCER Phone: 650-573-1111 N AME: Janet MacDougall Andreini & Company-San Mateo PHONE FAX License 0208825 Fax: 650-378-4361 A/C No Ext : 925-242-2619 A/C, No): 220 West 20th Ave ni.com g San Mateo, CA 94403 ADDRESS:macdou all andrei INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : National Union Fire Ins Co PA 19445 INSURED VSS International, Inc. INSURER B: Starr Indemnity & Liability Co 38318 dba: VSS Emultech INSURER C: Travelers Property Casualty 36161 3785 Channel Drive West Sacramento, CA 95768 INSURER 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 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 EFF POLICY EXP LTR POLICY NUMBER MM DD YYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 5610628 03/01/2015 03/01/2016 DAMA T RENTED 100 000 A X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE FXIOCCUR MED EXP (Any one person) $ 10,000 X Deduc$1,000,000 PERSONAL BADVINJURY $ 2,000,000 X OCIP Excluded GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 jECT RO LOC $ POLICY X P AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident $ A X ANY AUTO 6579252 03/01/2015 03/01/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY TY DAMAGE $ AUTOS X Deduc $1 mm X OCIP Exclu MCS 90 $ Include UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B X EXCESS LIAB CLAIMS-MADE 1000021595 03/01/2015 03/0112016 AGGREGATE $ 10,000,000 DED RETENTION $ $ WORKERS COMPENSATION STATU- OTH- AND EMPLOYERS' LIABILITY TWC ORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y /❑N X CALIFORNIA SELF INSURED E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) ID,NV,NM,TX,UT#049342394 03101/2015 03101/2016 E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Leased/Rented Equi QT-630-7444L337-TIL-15 03101/2015 03101/2016 Any One 750,000 Item DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION ASHASH1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Drive Ashland, OR 97520 AUTHORIZED REPRESENTATIVE -7,-- / C, ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD