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HomeMy WebLinkAboutInsurance Certificate: Rogue Waste Systems LLC Client#: 1137013 ROGUEWAS ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE 913(MMIDD (MMIDDlYYYY) 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: Ifthe 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 AIC, No, Ext : AIC, No): 975 Oak Street, Suite 900 ADDR1ESS: teresa.weston@usi.biz Eugene, OR 97401 INSURER(S) AFFORDING COVERAGE NAIC# 541 685-5300 INSURER A: Greenwich Insurance Company 22322 INSURED INSURER B: SAIF Corporation 36196 Rogue Waste Systems LLC INSURER C One West Main Suite 401 INSURER D : Medford, OR 97501 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 NADDLSUBR SR WVD POLICY NUMBER MMO/LDOY'YYYY MMIDDY!_YEYXYIP' LIMITS A X COMMERCIAL GENERAL LIABILITY GE0003582704 1010112015 1010112016. EACH OCCURRENCE $1,000,000 CLAIMS-MADE ~ OCCUR DAMAGE occcurr nce $100,000 X BIIPD Ded:1,000 MED EXP (Anyone person) $5,000 PERSONAL & A.DV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $2,000,000 JECT LOC PRODUCTS COMP)OPAGG $2,000,000 POLICY 1-1 PRO- OTHER', $ AUTOMOBILE LIABILITY AE0003582404 10101/2015 101011201 Eat ae~NeDSINGLE LIM.T 1,000,000 A X ANY AUTO BODILY INJUR"(Per person $ ALL OWNED SCHEDULED BODILY '.NJUR" (Per accident) $ AUTOS NONOOVJNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION 519473 10/01/2015 10/01/201 PER OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUT!VE Y I N F L EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? N / A EL DISEASE - EA EMPLOYEE $1 000 ,000 (Mandatory in NH) Dyes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY L'MIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 1D1, Additional Remarks Schedule, may be attached 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 DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main St. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97502-0000 AUTHORIZED REPRESENTATIVE w4! © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S 16341564IM 16341550 TRWJ R