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HomeMy WebLinkAboutInsurance Certificate: JACO Environmental AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) V...~,. 09/22/2015 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: Applied Risk Services, Inc. /C, No, EXt) (877)234-4420 (A/C, No): (877)234-4421 10825 Old Mill Rd E-MAIL Omaha, NE 68154 ADDRESS: PRODUCER CUSTOMER ID # (877)234-4420 - - - INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A. California Insurance Co. 38865 JACO Environmental, Inc. INSURER B: dba JACO Envirc mlental, Inc. INSURER C. 18323 Bothell Everett Hwy #220 INSURER D. Bothell, WA 98012-5246 INSURER E. CTL 1273 1074318 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. ADDL. SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MWDD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE= S COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED CLAIMS - PREMISES (Ea occurrence) $ MADE . OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER: - - .PRODUCTS - COMP/CP AGO $ POLICY PROJECT LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE ~-IMIT ANYAUTO (Ea acc dent) $ ALL OWNED AUTOS BODILY INJURY(Perpe-w $ SCHEDULED AUTOS BODILY INJURY (PeracudeniL PROPERTY DAMAGE HIRED AUTOS (Per accident) S NON-OWNED AUTOS $ S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE - RETENTION $ IS WORKERS COMPENSATION WC STATU- 'OTH AND EMPLOYERS' LIABILITY Y/N X.TORY _LIMITS ER ANY PROPRIETOR/PARTNER, - EL EACH ACCIDENT $ 1,000,000 A EXECUTIVE OFFICER/MEMBER N N/A 73-877317-02-01 09/15/2015 09/15/2016--- ' EXCLUDED? (Mandatoryin NH) EL. DISEASE-EA EMFLOVEE_ !IS 1, 000,000 If yes.. describe under SPECIAL PROVISIONS below E.L. DISEASE-POLICVLIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 90 N. Mountain Avenue EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Igo Attn: Purchasing Representative 81 1539 ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ©1988-2009 ACORD CORPORATION. All rights reserved.