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HomeMy WebLinkAboutInsurance Certificate: Industrial Software Solutions INDUS-5 OP ID: 1JL Y) CERTIFICATE OF LIABILITY INSURANCE 11 1DATE F(MM/ 23/22015 015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON, '.Y 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 Brown & Brown of WA. Inc. (B) PHONE- Jenniffer Lawson, CIC, CISR FAx 1501 4th Ave Suite 2400 A/C. No Extl: 206-388-0797 tac Nol 206-956_-9747 Seattle, WA 98101 E-MAIL law J'0'_ Roger Young ADDRESS: 1 _ @bnbseattle.com INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A : CHARTER OAK FIRE INSURANCE CO. 2556155 INSURED Industrial $Oftware SOIUtIOnS, INSURER B : Travelers Property & Casualty 25674 Inc; I Connectivity, LLC; - - ISS Productivity, LLC; INSURER C: ISS Wonderware, LLC INSURER D : 19909 120th Ave NE #101 - - - - Bothell, WA 98011 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 AFFOKUED 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 UBR - LTR TYPE OF INSURANCE IN D YJVD POLICY NUMBER MMIDDYIYYYY MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS MADE OCCUR X ZLP-14T51135 12/01/2015 12101/20161 DAMAGE TO RENTED PREMISES (Ea occurrence $ 300,00 _ ;EO DEDUCTIBLE M_ED EXP (Any_ one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000,00 ~ X POLICY PRO- JECT L~ LOC PRODUCTS - COMP/OP AGG $ - 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 B X 12/07/2016DILY INJURY (Per person) $ - AANY UTOS NOD SCHEDULED X BA6CO53562 12/01/2015 "Ea aLY IN tom.. ALL BODILY INJURY Per accident HIRED AUTOS NON-OWNED J PROPERTY DAMAGE , AUTOS Per accident $ X B 1 i EXCESS UMBRELLA LIAB LIAB OCCUR EAC X CLAIMS-MADE .ZUP-14T51147 112/01/20751 12/07/2016 ~HOCCURRENCE ' $ 4,000,00 AGGREGATE $ 4,000,00 DED RETENTION $ 10,000' r $ WORKERS COMPENSATION X A ANY PROPRIETOR/PARTNER/EXECUTIVE U66828M066 10/1512015 10115/2016 E.L.EACH ACCIDENT $ 500,00 O DICER/ I EBER EXCLIUER/E Y I N NIA k STATUTE OR H (Mandatory in NH) E EASE - EA EMPLOYEE $ 500,00 yes, describe under 7 SCRIP ION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 i DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 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 Avenue Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD