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HomeMy WebLinkAboutInsurance Certificate: SME Solutions Client#: 335759 SMESOLUT ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) (MM/D 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(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 NAMEACT Rhonda Scialpi USI Northwest WC PHONE 503 295-8321 FAX (A/C No, Exit): (AIC, No): 610 362-8185 700 NE Multnomah, Suite 1300 E-MAIL ADDRESS:RhondascialPI@usi.biz Portland, OR 97232 INSURER(S) AFFORDING COVERAGE NAIC # 503 224-8390 INSURER A : SAIF Corporation 36196 INSURED INSURER B : Zurich American Insurance Compa 16535 SME Solutions, LLC 680 Quinn Ave. INSURER C San Jose, CA 95112 INSURER D INSURER E : i 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. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER - (MM/DD/YYYY-(MM/DD/YYYY LIMITS ii LIABILITY OCCUR EACH OCCURRENCE $ COMMER IALCLAIMS-MADE GENERAL ~II DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) S PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: 'i GENERAL AGGREGATE $ F7 PRO- LOC JECT PRODUCTS -COMP/OP AGG IS POLICY i OTHER: _ $ AUTOMOBILE LIABILITY I-COMBINED SINGLE LIMIT t _ 'Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS _ AUTOS - HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DID I RETENTION$ A WORKERS COMPENSATION 992634 10/01/2015 10/01/2016 X I PER I OTH- j AND EMPLOYERS' LIABILITY -.STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT S1,000,000_ OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under E.L. DISEASE -POLICY LIMIT $1,000,00_0_______ DESCRIPTION OF OPERATIONS below B Workers Comp 8997923 10/01/2015 10/01/2016; 1000/1000/1000 I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Supplemental Name First Supplemental Name applies to all policies - SME Solutions, LLC CERTIFICATE HOLDER CANCELLATION City of Ashland, Purchasing Rep. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y 9 p. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Kari Olson ACCORDANCE WITH THE POLICY PROVISIONS. 90 N Mountain Ave Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S16293916/M16290877 KDMZP