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HomeMy WebLinkAboutInsurance Certificate: Taurus Power & Controls ~ ACCOM7 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/9/2017 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). CONT PRODUCER NAMEACT Louise Cook Rey Insurance & Benefits Services APHO CNE Ext: (585) 546-3747 FAX (585)424-2798 A/C No 777 Canal View Blvd, Suite 100 E-MAIL Louise.cook@key.insurance ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Rochester NY 14623 INSURERA:Llo ds of London AA112200 INSURED INSURER B:Evanston Insurance Co 35378 Taurus Power & Controls, Inc. INSURERC:Federal Insurance Company 20281 9999 S.W. Avery Street INSURER D: INSURER E : Tualatin OR 97062 INSURER F: COVERAGES CERTIFICATE NUMBER:17-18 Liability 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 LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED 11000,000 A CLAIMS-MADE ❑ OCCUR PREMISES Ea occurrence $ X BINDER ESE02166375 1/12/2017 1/12/2018 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 POLICY X PRO- a LOC PRODUCTS - COMP/OPAGG $ 2,000,000 JECT OTHER: Pollution Liability $ 2,000,000 AUTOMOBILE LIABILITY Ee acccidentSINGLE LIMIT $ 2,000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS X BINDER ESE02166375 ' 1/12/2017 1/12/2018 BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTIONS BINDER MKLV10LE105784 1/12/2017 1/12/2018 $ PR WORKERS COMPENSATION X STATUTE EERH AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE N /A E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? LNN] 71725180 1/12/2017 1/12/2018 C (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 11000,000 A Professional Liability BINDER ESE02166375 1/12/2017 1/12/2018 Each claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The city, and its agents, officers, and employees. 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 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Bruce Rogers/LCOOK © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NS025 (201401) AGENCY CUSTOMER ID: 00132907 LOC As applicable AC40 ® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Key Insurance & Benefits Services NAMED INSURED Taurus Power & Controls, Inc. POLICY NUMBER See page 1 CARRIER NAIC CODE See page 1 See p 1 EFFECTIVEDATE: 1/12/2017 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 & 24 FORM TITLE- Certificate of Liability Insurance & Certificate of Property Insurance To the extent covered by endorsement form(s): General Liability: (No form number or edition date applies) - Controlled Systems Amendatory Clause (includes Additional Insured, Primary and Non-Contributory, Difference in Conditions and Waiver of Subrogation). Difference in Conditions section includes ISO forms CG2010 (10/01), CG2037 (10/01) and CG2404 (10/93). Workers' Compensation & Employer's Liability: W0000106A (4/92) - Longshore and Harbor Workers' Compensation Act Coverage Endorsement (Oregon) W0000303C (10/04) - Employer's Liability Coverage Endorsement (WA Stop Gap Liability) W0000313 (4/84) - Waiver of Our Right to Recover From Others Endorsement WC040101A (4/92) - Longshore and Harbor Workers' Compensation Act Coverage Endorsement - California WC990304 (7/08) - Waiver of Our Right to Recover From Others Endorsement - California Excess Liability: MAUB0001 (01/15) - Commercial Excess Liability Policy MAUB1512 (01/15) - Changes - Primary And Noncontributory MAUB1245 (01/15) - Waiver Of Transfer Of Rights Of Recovery Against Others To Us Property: 80020280 (07/03) - Schedule of Mortgagees/Loss Payees ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. INS101 (200801) The ACORD name and logo are registered marks of ACORD