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HomeMy WebLinkAboutInsurance Certificate: Measure- Tech Inc Phone: (541)488-6002 Fax: (541)488-5311 ..------" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) ACORO ‘,..---- 07/25/2019 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 ALMEA Insurance, Inc. 201 NE Park Plaza Dr#293 INC.No.Ext); 360-694-7994 - - ,J FAX No):3604944575 E-MAIL Vancouver, WA 98684 ADDRESS: sboatright@almeainsurance.com License#: 920891 INSURER(S)AFFORDING COVERAGE NAIC S INSURERA: Houston Specialty Insurance Company INSURED INSURER B: Austin Mutual Insurance Company 24082 i Measure-Tech, Inc. INSURER C: National Union Fire Insurance Company of Pittsb PO Box 499 INSURER D: Ariel, WA 98603 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-2224990 REVISION NUMBER: 109 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 SUER POLICY EFF POLICY EXP LIMITS LTR INSD VIM POLICY NUMBER (MWDD/YYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL UABIUTY Y Y TEN-23603 07/29/2019 07/29/2020 EACH OCCURRENCE S 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea Eoccurrence) $ 100,000 MED EXP(Any one person) S 5,000 PERSONAL B ADV INJURY $ 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY JECT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: S B AUTOMOBILE LIABILITY BA1927398 12/03/2018 12/03/2019 (EOaactideDSINGLELIMIT a 1,000,000 ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S X AUTOS ONLY X AUTOS -- HIRED X NON-OWNED PROPERTY DAMAGE S X AUTOS ONLY /�AUTOS ONLY _(Peraccident) S `` X UMBRELLA LIAB X OCCUR EBU013299345 07/29/2019 07/29/2020 EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE _ S 5,000,000 DED I RETENTIONS Crisis response S 250,000 A WORKERS COMPENSATION YIN TEN-23603 07/29/2019 07/29/2020 X STATUTE OTH- ER Stop Gap ' AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE l 1 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? I 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 S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Ashland,Oregon,and its elected officials,officers and employees are named as additional insured for both ongoing CG2010 and completed CG2037 operations when required by written contract. Excess liability is follow form.Coverage is primary and non-contributory per forrm TEN0215.Waiver of Subrogation applies per form CG 2404.Workers Compensation is through the State of Washing,current certificate attached,and WA Stop Gap/Employers Liability is afforded through form CG 0442. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland, Oregon ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland,OR 97520 AUTHORIZED REPRESENTATIVE jitost4a/61fre (SHB) ©1988-201 CORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by SHB on July 25,2019 at 09:37AM