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HomeMy WebLinkAboutInsurance Certificate: UNAVCO Inc. ACc°® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 11/7/2017 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 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). PRODUCER CONTACT NAME: James Martinez Arthur J. Gallagher Risk Management Services, Inc. PHONE 303-889-2526 Fac,Ncl: 720-200-5115 6300 South Syracuse Way, Suite 700 (A/C,Nn.Ft�' Centennial CO 80111 ADDRESS:James_Martinez @ajg.com INSURER(S)AFFORDING COVERAGE NAIC• INSURER A:Federal Insurance Company 20281 WISURED INSURERB: UNAVCO Inc. INSURER C: 6350 Nautilus Drive Boulder, CO 80301 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1881826687 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. ADUL 5UBH POLICY EFF POLICY EXP LLTTRR TYPE OF INSURANCE INS() WVD- POLICY NUMBER (MMUDDIYYYY) ONMVDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 35988128 11/1/2017 11/1/2018 EACH OCCURRENCE $1,000,000 OAMAGE TO RENTED-- CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY PET LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: 11/1/2017 11/1/2018 MAIMED SINGLE Mir $ A AUTOMOBILE LIABILITY 73581997 (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY _(Per accident) $ A X UMBRELLA LIAB X OCCUR 79887838 11/1/2017 11/1/2018 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$0 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ERN ANY PROPRIETOR/PARTNER/EXECUTIVE nY YIN E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? I I N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: GPS site P370 (Ashland Municipal Airport). The City of Ashland, Oregon an Oregon Municipal Corp. is included as Additional Insured on the General Liability Policy if required by written contract or agreement subject to the policy See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland,Oregon an Oregon Municipal Corp. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E. Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 USA AUTHORIZED REPRESENTATIVE Z ■■ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: ACORO ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Arthur J. Gallagher Risk Management Services, Inc. UNAVCO Inc. --- 6350 Nautilus Drive POLICY NUMBER Boulder, CO 80301 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE terms and conditions. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD