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HomeMy WebLinkAboutInsurance Certificate: Metals Treatment Technologies Client: 33569 METTREPC ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 09/(MM/DD (MM/DD/YYYY) 9 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nick Brown NAME: Holmes Murphy - Colorado PHONE 720-458-5770 A/CFAX, No): A/C No Ext : 844-248-0468 7600 East Orchard Road, Suite 230 South E-MAIL ADDRESS: nbrown@holmesmurphy.com Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Starr Surplus Lines Insurance Company 13604 INSURED INSURER B : Starr Indemnity & Liability Company 38318 Metals Treatment Technologies, LLC INSURER C: AGCS Marine Insurance Company 22837 14045 West 66th Avenue INSURER D : Arvada, CO 80004 INSURER E : I INSURER F : COVERAGES CERTIFICATE NUMBER: 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 !NDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 SUB POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X 1000067113191 10/01/2019 1010112020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ~ OCCUR PREMISESOEaoN.EDnce $100,000 X BI/PD Ded: $2,500 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- PRODUCTS - COMP/OPAGG s2,000,000 LOC POLICY a JECT F OTHER: $ INGLE LIMIT $1,000,000 B AUTOMOBILE LIABILITY SISIPCA08275019 10/01/2019 10/01/202 COEaaMccidBINED entS $ X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPccERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per aident A UMBRELLA LIAB X OCCUR 1000337409191 10/01/2019 10/01/202 EACH OCCURRENCE s8.000.000 X EXCESS LIAR CLAIMS-MADE AGGREGATE s8,000,000 DED X RETENTION $0 $ B WORKERS COMPENSATION 100000148905 10/01/2019 10/01/202 X PEAT ORH AND EMPLOYERS' LIABILITY ANY PROP RIETOR/PARTNER/EXECUTIVE Y / N E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? F7Y N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under I DESCRIPTION OF OPERATIONS be!ow F.L. DISEASE - POLICY LIMIT $1,0001000 C Leased/Rented Eq. SML93024512 10/01/2019 101011202 $1,000,000; $1,000 Ded C Installation Flt. SML93024512 10/01/2019 10/01/202 $1,000,000; $1,000 Ded A Pollution/Prof. 1000067113191 10/01/2019 10/01/202 $1 Mil Occ/$2Mil A DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Ashland Gun Club Trap/Skeet Range As required by written contract or written agreement, the City of Ashland, Oregon, and its elected (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E. Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S477647/M477573 MANV1 DESCRIPTIONS (Continued from Page 1) officials, officers and employees are included as Additional Insured under General Liability and Automobile Liability on a primary and non-contributory basis with respect to the above referenced. SAGITTA 25.3 (2016/03) 2 of 2 i #5477647/M477573