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HomeMy WebLinkAboutInsurance Certificate: Reporting Systems, Inc F DATE (MM/DD/YYYY) ACC" CERTIFICATE OF LIABILITY INSURANCE 5/31/2018 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 _ NAME: Scott Figueroa HUB International Northwest LLC PHONE FAX 110 Unity Street ACA Lo Ext : 360-647-9000 A/c No): 360-734-8496 E-M DDRESS: now.bellinghaminfo@hubinternational.com Bellingham WA 98225 A INSURER S) AFFORDING COVERAGE NAIC # INSURER A : Sentinel Insurance Company, Ltd. 11000 INSURED REPOSYS-01 INSURER B : Hartford Accident and Indemnity Company 22357 Reporting Systems, Inc. INSURER C : Hartford Fire Insurance Company 19682 DBA Emergency Reporting - - - 2200 Rimland Drive, Ste. 305 INSURER D Bellingham WA 98226 INSURER E:- INSURER F : COVERAGES CERTIFICATE NUMBER: 1154815606 REVISION NUMBER: 1 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 1ADDL SUBIR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD'WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y 52SBAAB1503 6/1/2018 6/1/2019 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE lxl OCCUR PREMISESIEa occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE _ _$_4,000,000 X POLICY CJ PRO- LOC PRODUCTS - COMP/OP AGG $ 4,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y 52UECHC1043 6/1/2018 6/1/2019 COMBINED SINGLE LIMIT $ _ Ea accident 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS 'BODILY INJURY (Per accident) $ X NON-OWNED j PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident A X UMBRELLA LIAB X OCCUR 52SBAAB1503 6/1/2018 6/1/2019 EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED X 1 RETENTION $ in flon $ WORKERS COMPENSATION 1 PERT X OTH- AND EMPLOYERS' LIABILITY STAUTE ER Stop Gap Y/N E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A OFFICERJMEMBER EXCLUDED? 1 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 1,000,000 C Technology Liability 52TE0329807 6/1/2018 6/1/2019 Each Wrongful Ad 1,000,000 Aggregate 1,000,000 Retention 5,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Per forms and conditions: Additional Insured and Waiver of Subrogation are included in the following forms, Business Liability Coverage form SS 00 08 04 05; Auto Broad Form Endorsement HA 99160312. 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. City of Ashland 90 N Mountain Ave AUTHORIZED REPRESENTATIVE Ashland OR 97520 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD