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HomeMy WebLinkAboutInsurance Certificate: David Evans & Associates ACOREY CERTIFICATE OF LIABILITY INSURANCE P ATE(MM/DD/YYYY) 12/1/2017 11/29/2016 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 have ADDITIONAL INSURED provisions or 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). CONTCT PRODUCER Lockton Companies N AME: 444 W. 47th Street, Suite 900 HOE Ext : AFAX /c, No Kansas City MO 64112-1906 E-MAIL (816) 960-9000 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A : Zurich American Insurance Company 16535 INSURED DAVID EVANS AND ASSOCIATES, INC. INSURER B : Lloyds of London 1331235 2100 SW RIVER PARKWAY INSURER C PORTLAND OR 97201 INSURER D : INSURER E : INSURER F : COVERAGES DEAIN01 CERTIFICATE NUMBER: 12314781 REVISION NUMBER: XXXXXXX 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 WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y N GLO 9830389 12/1/2016 12/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ~ OCCUR DAMAGE TO RENTED $30O 000 PREMISES Ea occurrence MED EXP An one person) $10,000 PERSONAL & ADV INJURY $ S1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ $2,000,000 POLICY PROT- LOC PRODUCTS - COMP/OP AGG $ S2,000,000 OTHER: $ acccdentSI . LIMIT $ S1,000,000 A AUTOMOBILE LIABILITY Y N BAP 9830390 12/1/2016 12/1/2017 CO X ANY AUTO BODILY INJURY (Per person) $ XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident $ XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per acciden $ XXXXXXX t $XXXXXXX 11 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION $ $ A AND WORKERS EMPLOYERS' COMPENSATION LIABILITY Y/ N N WC 9336626 12/1/2016 12/1/2017 X STATUTE OER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L. EACH ACCIDENT $ 1,000,000 Mand tory in NH) EXCLUDED? E.L. DISEASE - EA EMPLOYEE 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT 1.000,000 B PROFESSIONAL N N LDUSA1604625.12!1/2016 12/1/2017 PER CLAIM $1,000,000 LIABILITY ANNUAL AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ASHL0000-005 CITY OF ASHLAND PLAN REVIEW. THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE ADDITIONAL INSURED WITH RESPECT TO GENERAL AND AUTO LIABILITY, THESE COVERAGES ARE PRIMARY AS REQUIRED BY WRITTEN CONTRACT. ADDITIONAL INSURED'S COVERAGE IS EXCESS AND NON-CONTRIBUTORY ON THE GENERAL LIABILITY, AND ON THE AUTO LIABILITY AS RESPECTS TO USE OF VEHICLES OWNED BY DAVID EVANS AND ASSOCIATES, INC. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12314781 AUTHORIZED REPRESENTATIVE CITY OF ASHLAND ATTN: BETSY HARSHMAN, ADMIN. SUPERVISOR 20 EAST MAIN STREET ASHLAND OR 97520 ACORD 25 (2016/03) ©1 8-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD