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Home My WebLink AboutInsurance Certificate: SME Solutions LLC m:George Petersen Insurance Agency To:SNE Solutions/Renewal Certificate(s) of Liabili (15414885320) 12:01 03/1915 EST Pg 2-3 SMESOLU-CL ILICHAU ACORLJ r ~y CERTIFICATE OF LIABILITY INSURANCE DATE 31(MMIDD (MM/DD/YYYY) 5 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(les) 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: George Petersen Insurance Agency, Inc. PHONE 525-4150 Arc No : 707 525-4175 P.O. Box 3539 A/C No Ell : (707) Santa Rosa, CA 95402 ADDRIESS: info@gpins.com INSURER(S) AFFORDING COVERAGE NAIC N INSURER A : Homeland Insurance Company of New York INSURED INSURER e : Nationwide Mutual Insurance Company 23787 SME Solutions, LLC INSURER C : 10107 S Tacoma Way, Suite A-2 INSURER D : Lakewood, WA 98499 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD~YY (MM/VDDNYYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 7,000,000 CLAIMS-MADE OCCUR X 793-00-22-82-0000 0611412014 06114/2015 PREMISES (()EHaTcl ED__ $ 50,000 urrence X Pollution Liab MED EXP (Any one person) $ 5,000 X Professional Liab PERSONAL & ADV INJURY $ 7,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 7,000,000 PRO- F CT LOC PRODUCTS -COMP/OP AGG $ 7,000,000 POLICY X JE OTHER: A Stop Gap COv $ 1,000,000 MBINED SINGLE AUTOMOBILE LIABILITY (CEO, accident LIMIT $ 1 000>000 B X ANY AUTO CP BA 3007045605 03115/2015 03115/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED X HIRED AUTOS X AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION $ $ WORKERS COMPENSATION PER CTH- AND EMPLOYERS' LIABILITY Y I N STATUTE ER ANY PROPRIETORlPARTNER/EXECUTIVE ❑ N / A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additiond Remarks Schedule, may be attached if more space Is required) RE: Labor and Materials - City's Petro Vend card reader system City of Ashland is named as Additional Insured with respects to General Liability per form OBENV GE 301 (0211) , attached. 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 ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE L_ O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD o:George Petersen Insurance Agency To:SME Solutions/Renewal Certificate(s) of Liabili (15414885320) 12:02 03/19/15 EST Pg 3-3 Policy Number: 793-00-22-82-0000 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - FORM I This endorsement only modifies coverage provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS ENVIRONMENTAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization for which the Named Insured has agreed to provide insurance prior to loss as provided by this policy but only to the scope of insurance agreed to by the Named Insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury, property damage or environmental damage occurring after: (a) All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (b) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain the same. OBENV GE 301 (0211) Includes copyrighted material of Insurance Services Office, Inc. 1 of 1 Copyright 2011,OneBeacon Insurance Group E-INSURED rge Petersen Insurance Agency To:SME Solutions/Renewal Certificate(s) of Liabili (15414885320) 12:01 03/19/15 EST Pg 1-3 Copy to: Insured / Certificate Holder / Carrier Attached please find the Renewal Certificate(s) of Liability Insurance issued today on behalf of our client for your files. Please review for acceptability and feel free to contact our office should you require anything further. Thank you, Illythia Lichau, CISR Assistant License #01`31143 Direct Line: 707-525-4178 Fax: 707-525-4175 ilichau@gpins.com www.gpins.com George Petersen Insurance Agency and its Affiliates Note: The information in this E-Mail message is confidential. It is intended solely for the use of the individual(s) named above. If, you are the intended recipient, be aware that your use of any confidential, proprietary and/or personal information may be restricted by state and federal privacy laws. If ,you are not the intended recipient, VOL) should not distribute or forward this E-mail message. If you have received this E-mail in error, please immediately notify the sender and delete the material from any computer and/or server.