Loading...
HomeMy WebLinkAboutInsurance Certificate: Olsson Industrial Electric DATE (MM/DDlYYYY) AC'fJRD~ CERTIFICATE OF LIABILITY INSURANCE 0511512017 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 CONTACT Marsh USA InC. NAME: - _ 13015th Avenue, Suite 1900 _~ai~Nr o Ext : a( !C' No): _ Seattle, WA 98101 E-MAIL Attn: Seattle.CertRequest@marsh.com 1 F:212-948-4326 ADDRESS: _ INSURER(S) AFFORDING COVERAGE NAIC # _ 21340 -NA_E_S-GAWU-17-18 _ INSURER A :Zurich American Insurance Company 16535 INSURED American Zurich Insurance Co. 40142 Olson Industrial Electric Inc. INSURER B : _ 1180 NW Maple Street, Suite 200 INSURER c :ACE Property And Casualty Ins Co _ 20699 Issaquah, WA 98027 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: SEA-003009474-16 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISI~ED 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 DOCUh4ENT WITH RESPECT TO WIiICIi THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TtIE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDD/YYYY ~MM DDIYYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY GL05574116-04 0512012017 0512012018 EACH OCCURRENCE _ $ 1,000,000 DAMAGE TO RENTED 1,000,000 CLAIMS-MADE a OCCUR PREMISES (Ea occurrence X SIR $200,_0_00 _ _ MED EX_P (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ~ PRO- ❑ LOC PRODUCTS -COMP/OP AGG $ 2,000,000 JECT OTHER: $ A AUTOMOBILE LIABILITY BAP9830191-07 0512012011 05120!2018 COMBINED SINGLE LIMIT $ 1,000,000 _ Ea acadent) X ANY AUTO BUDILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS _ _ NON-OWNED PROPERTY DAMAGE $ _ HIRED AUTOS AUTOS _~er accident) _ _ COMPICOLL DED $ 5,000 G X UMBRELLA LIAB OCCUR XOC 627833238003 0512012017 0512012018 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB X CLAIMS-MADE AGGREGATE $ DED X RETENTION $1,000,000 $ B WORKERS COMPENSATION WC5574111-04(AOS) 0512012017 0512012018 X PER oTH- ANDEMPLOYERS' LIABILITY STATUTE _ .ER B Y 1 N WC5514118-04 WI 0512012017 0512012018 1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE N NIA ( ) E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS !VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) The City of Ashland, Oregon and ifs elected officials, officers and employees are included as additional insured where required by written contract and allowed bylaw with respect to General Liability, Automobile Liability, and Umbrella Liability. This insurance shall be primary and non-contributory and limited to liability arising out of the operations of the named insured when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Beverly A. Wold ~Q~, y l! ~~1~/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD