Loading...
HomeMy WebLinkAboutInsurance Certificate: Taurus Power & Controls (2) ArcoT MM/DD/YYYY) ® CERTIFICATE OF LIABILITY INSURANCE DATE(( M2016 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 Louise Cook NAME: Key Insurance & Benefits Services (aC PHONE Ext►: (585)546-3747 FAX No):(585)424-2798 777 Canal View Blvd, Suite 100 E-MAIL Louise.cook @ke insurance ADDRESS: y' INSURER(S)AFFORDING COVERAGE NAIC# Rochester NY 14623 INSURERA:Lloyds of London 085202 INSURED INSURER B Evanston Insurance Company 35378 Taurus Power & Controls, Inc. INSURERC:Chubb Indemnity Insurance Co 12777 9999 S.W. Avery Street INSURERD: INSURER E: Tualatin OR 97062 INSURERF: COVERAGES CERTIFICATE NUMBER:18-19 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD MD POLICY NUMBER (MMIDD/YYYY) (MM/DDM/YYl X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS-MADE X OCCUR DAMAGE GE TO RENTED ISES(Ea occurrence) $ 1,000,000 X X VBE03232A18 1/12/2018 1/12/2019 MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 POLICY X ' X LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Pollution Liability $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 (Ea accident) A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS X VBE03232A18 1/12/2018 1/12/2019 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS R AUTOS (Per accident) UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000_ B x EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ RENEWAL OF NRLV1EUL100532 1/12/2018 1/12/2019 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 C Mandatory in NH)EXCLUDED? N 71725180 1/12/2018 1 12/2019 (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 A Professional Liability VBE03232A18 1/12/2018 1/12/2019 Each Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 1 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Bruce Rogers/LCOOK -�"�j — ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(2014011 AGENCY CUSTOMER ID:00132907 LOC#: As applicable AR D ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Key Insurance & Benefits Services NAMED INSURED Taurus Power & Controls, Inc. POLICY NUMBER 9999 S.W. Avery Street See page 1 Tualatin, OR 97062 CARRIER NAIC CODE See page 1 See p 1 EFFECTIVE DATE: 1/12/2018 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 to the following) : Additional Insured Endorsement (by written contract or agreement) ; includes primary insurance language where required by a written contract or agreement. ISO Endorsement (In respect of General Liability Coverage Endorsement only, it is understood and agreed that in the event that a claim is made which falls outside of the scope of coverage provided by this Policy but would fall within the scope of coverage provided by the named ISO forms, for the purposes of this claim the named ISO forms' terms and conditions will apply. It is further understood and agreed that named ISO forms are defined as follows: CG 20 37 10 01, CG 20 10 10 01, CG 24 04 10 93, CG 20 38 04 13. All other terms and conditions remain unchanged.) Liberalisation Clause Workers' Compensation & Employer's Liability: WC000106A (4/92) - Longshore and Harbor Workers' Compensation Act Coverage Endorsement (Oregon) WC000303C (10/04) - Employer's Liability Coverage Endorsement (WA Stop Gap Liability) WC000313/WC124 (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: MADUB0001 (01/15) - Commercial Excess Liability Policy MAUB1512 (09/16) - 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 Key Insurance &Benefits Services Please find enclosed a certificate of insurance. This certificate does not amend, extend or alter coverages afforded by the policies of insurance set forth on the certificate. All insurance afforded is subject to all of the terms, exclusions and conditions of those policies. Several states have adopted Insurance Law that prohibits an insurer, agent or broker from including terms, conditions, or language of any kind, including warranties or guarantees, if the insurance policy referenced by the certificate does not expressly include the terms, conditions, or language. In an effort to comply with the laws, many agencies have adopted the Acord 101 form as a way of clearly listing the coverage forms and edition dates that are attached to the policies. We are happy to provide copies of these forms or policy documents upon request. �,I