HomeMy WebLinkAboutInsurance Certificate: UNAVCO Inc
ACCOR" ® DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 1114/2015
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 endorsements .
PRODUCER CONTACT
NAME: James Martinez
Arthur J. Gallagher Risk Management Services, Inc. PHONE - - - FAX - -
6399 S. Fiddlers Green Cir UVC, No. Ext): 303-889-2526 - - (,,,,,o):_720-200-51 15
E-MAIL
Suite 200 James_Martinez9afig'com
AODRE_S5;
- -
Greenwood Village CO 80111 INSURER(S) AFFORDING COVERAGE NAIC
INSURER A : Federal Insurance Company 20281
INSURED
INSURER B
UNAVCO Inc.
INSURER G
6350 Nautilus Drive - - - - - -
Boulder, CO 80301 INSURER D :
INSURER-E,:_
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1986364159 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.
INTR - TYPE OF INSURANCE - NDDD iSUBR' POLICY EFF -POLICY EXP _
WVD POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY 35988128 11(1/2015 11/10016 EACH OCCURRENCE 51,000,000
DAMAGE 1 O K:ENTED
CLAIMS-MADE X 'OCCUR PREMISES (Ea occurrence) $1,000,000
MED EXP (Anyone person) $5,000
PERSONAL & ADV INJURY $1,000,000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000
POLICY PRO
X LOC
JECT PRODUCTS - COMPlOP AGG $2,000,000
_
OTHER: $
A AUTOMOBILE LIABILITY 73581997 1111/2015 111112016 SINGLE CrJMBINED $1,000,
(Ea accident) 000
X ANY AUTO BODILY INJURY (Per person) $
- - - - - -
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY (Per accident) 5
NON-OWNED - PROPERTY accident) DAMAGE
' HIRED AUTOS AUTOS 5
_ (Per accident)
A X UMBRELLA LIAB X OCCUR 79887838 11/1/2015 11/1/2016 EACH OCCURRENCE 52.000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE 52,000,000
_ -
DED X RETENTION 50 K
WORKERS COMPENSATION PER OTH.
AND EMPLOYERS' LIABILITY STATUTE__ _ ER
YIN - - ,ANY PROPRIETOR/PARTNER/EXECUTIVE 1 NIA
E L EACH ACCIDENT 5
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE s
Ves, describe under - - - - -
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: GPS site P370 (Ashland Municipal Airport). The City of Ashland, Oregon an Oregon Municipal Corp. is included as
Additional Insured on the General Liability Policy if required by written contract or agreement subject to the policy
terms and conditions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland, Oregon an Oregon Municipal Corp. ACCORDANCE WITH THE POLICY PROVISIONS.
20 E. Main Street
Ashland OR 97520 USA AUTHORIZED REPRESENTATIVE
(d) 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD