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HomeMy WebLinkAboutInsurance Certificate: Diamond Parking Services I DIAM001 OP ID: DG CERTIFICATE OF LIABILITY INSURANCE 0 DAT7/12DIYYYY) 07/12/13 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). PRODUCER 206 CONTACT AME: ONE Daphne M. Gellhaus FAx PRODUCE-Worthington LLC -285-7735 PH P.O. Box 607 Bothell WA 98041 206-285-3461 A/C No Ext : 206-838-1042 A/C No): 425-486-6140 424 Third Ave W A DRESS I Seattle, WA 98119 : daphne@lovstedworthington.com Se Dean R. Young INSURER S) AFFORDING COVERAGE NAIC # INSURER A : Philadelphia Ins. Co. INSURED Diamond Parking Services, LLC INSURER B : Philadelphia Ins. Co. Diamond Parking Services, LLC INSURER C : Employers Ins Co of Wausau 605 First Avenue, Suite 600 Seattle, WA 98104 INSURER D : 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 AFFORDED MY 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 tADDL IU-BR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 ,000,000 A X COMMERCIAL GENERAL LIABILITY PHPK1048696 07/15113 07/15/14 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE X OCCUR MED EXP (Any one person) $ Excluded X Stop Gap PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO- JFCT X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 r, ANY AUTO X PHPK1048696 07115113 07/15/14 BODILY INJURY (Per person) $ X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 51000,000 B X EXCESS LIAB CLAIMS-MADE PHUB428422 07/15/13 07115/14 AGGREGATE $ 5,000,000 DED X RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMIT X ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCCZ91452389012 07/15/13 07/15/14 E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under ~ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Station #EA01 - City of Ashland, Ashland, OR Certificate holder is an additional insured CERTIFICATE HOLDER CANCELLATION ASHLA01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN On Street Parking ACCORDANCE WITH THE POLICY PROVISIONS. Enforcement 20 E Main Street AUTHORIZED REPRESENTATIVE Ashland, OR 97520 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD