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HomeMy WebLinkAboutInsurance Certificate: Industrial Software Solutions INDUS-5 OP ID: 1NG A`CO~RO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY} 0/18/2016 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). CONTA PRODUCER NAME: CT Jenniffer Lawson, CIC, CISR Brown & Brown of WA. Inc. (B) PHONE- 206-388-0797 a/c No}: 206-956-9747 1501 4th Ave Suite 2400 A/c No Ext : Seattle, WA 98101 E-MAIL Brown & Brown of WA INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Property & Casualty 125674 INSURED Industrial Software Solutions, INSURER B:TRAVELERS INDEMNITY CO OF CT '25682 Inc; ISS Connectivity, LLC; INSURER C: ISS Productivity, LLC; - ISS Wonderware, LLC INSURER o : 19909 120th Ave NE #101 INSURER E : Bothell, WA 98011 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 INSD WV POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 ~I CLAIMS -MADE X OCCUR X ZLP-14T51135 12/01/2015 12/01/2016 pREMISES0(Ea occur ante) $ 300,0 - I$0 DEDUCTIBLE MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,00 - - - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 PRO- X j POLICY JECT LOC PRODUCTS - COMP/OP AG, 2,000,00__ L 11 OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ 1,000,00 - r A X j ANY AUTO X BA6CO53562 12/01/2015 12/01/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS - - - NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ XI UMBRELLA LIAB X EACH OCCURRENCE $ 4,000,00 OCCUR - - - - - 0001 AGGREGATE $ 4,000,00 A EXCESS uAB CLAIMS-MADE ZUP-14T51147 12/01/2015 12/01/2016 1 ~ ~ 'DED X RETENTION $ $ 10,006 PER WORKERS COMPENSATION X S TATUTE FOR H T AND EMPLOYERS' LIABILITY Y/N B I ANY PROPRIETOR/PARTNER/EXECUTIVE UB6828MO66 10/15/2016 10/15!2017 E.L. EACH ACCIDENT $ 500,00 - OFFICER/MEMBER EXCLUDED? ❑ N I A 500,00C (Mandatory in NH) -E.L DISEASE - EA EMPLOYEES $ i If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS I 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Avenue Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD