HomeMy WebLinkAboutInsurance Certificate: UNAVCO
AC7"RD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
10/27/2016
F rHIS 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
1 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 - 303-889- - FAX 7
6300 South Syracuse Way, Suite 700 EV ANQ~Exv~2526 - 1A/c Np) 20-200-5115
Centennial C 80111 ADDRESS_James_Martinezajg com
INSURER(S) AFFORDING COVERAGE _NAIC a
INSURER A:Federal _Insurance Company 20281
INSURED INSURER B
UNAVCO Inc.
ENSURER C-:-
6350 Nautilus Drive - - - - - -
Boulder, CO 80301 INSURER D c -
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 532730240 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 IG SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1NSR ~ - TYPE OF INSURANCE-`~--_ -ADBCSUBR---- POLICY Ef=F POLICY EXP LIMITS
LTR INSD' WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
A X COMMERCIAL GENERAL LIABILITY 35988128 11/1/2016 1111/2017 EACH OCCURRENCE 51,000,000
- ,
-DAMAGE 10 RENTED 1,000,000
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) 5
-
MED EXP (Any one person) S5,000
PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000
X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG 52,000,000
OTHER: 5 - -
A AUTOMOBILE LIABILITY 73581997 1111/2016 1111/2017 (a accident) 51,000,000
X ANY AUTO BODILY INJURY (Per person) 5
ALL OWNED SCHEDULED INJURY AUTOS BODILY (Per accident) 5
NON-OWNED P'ROPER'TY DAMAGE C
HIRED AUTOS AUTOS (Per accident)
A X UMBRELLA LIAB X OCCUR 79887838 11/1/2016 11/1/2017 EACH OCCURRENCE 52,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE 52,000,000
DED X RETENTION $0 5
PER OTH-
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N ---STATUTE- ,_`__ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/ A E L EACH ACCIDENT 5
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH) E L. D15cASE EA EMPLOYEE 5
It yes, describe under -
DESCRIPTION OF OPERATIONS befo:v E.L. DISEASE - POLICY LIMIT 5
DESCRIPTION OF OPERATIONS / LOCATIONS / 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
City of Ashland, Oregon an Oregon Municipal Corp. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 E. Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland OR 97520
USA AUTHORIZED REPRESENTATIVE
,r 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD