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HomeMy WebLinkAboutInsurance Certificate: HazmatIQClient#: 1545117 FRSHOLI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/17/2019 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(les) 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 NAME: ONTAcr Debbie Archimbaud USI Insurance Services, LLC c A/C No877-506-0509 8540 Colonnade Center Dr. E-MAIL Suite 111 ADDRESS: debbie.archimbaud@usi.com INSURER(S) AFFORDING COVERAGE NAIC # Raleigh, NC 27615 INSURER A : Great Northam Insurance Company 20303 INSURED Tw i ' F. I 90AGn HazmatlQ by Federal Resources 235G Log Canoe Cir Stevensville, MD 21666-2165 INSURER B : n City ne nsurance Company INSURER C ' Trumbull Insurance Company INSURER D : INSURER E : COVERAGES CERTIFICATE NUMBER: RFVICInN NI11uROM. 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 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. IN R TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/Y LIMA A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR 35894855 2/01/2019 12/01/2020 EACH�,OECTCURRENCE $1 OOOOOO $1 000 000 PREMISES EaEoNcurrence MED EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECOT LOC OTHER: I GENERAL AGGREGATE $2 000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ C AUTOMOBILE LIABILITY ANY AUTO AUTOS ONLY SCHEDULED AUTOS AUTOS ONLY X NON -OWNED AUTOS ONLY 22UENBH6529 2/01/2019 12/01/202 COMBINED SINGLE LIMIT Ea accident 1,000,000 X X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE Per accident UMBRELLA LAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ $ $ AGGREGATE DIED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? FNI (Mandatory in NH) If yyes, describe under DESCRIPTION OF OPERATIONS below N / A 22WBAC30CU 2/01/2019 12/01/2020 X spTEARTLITE OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT 1$1.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Ashland, Oregon is included as additional insured for General Liability, Automobile Liability, and Professional Liability as their interest may appear as required by written contract. General Liability, Automobile Liability, and Professional Liability coverage is primary and non-contributory. The City of Ashford, Oregon 20 East Main Street Ashland, OR 97520-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O*e-, z ACORD 25 (2016/03) 1 of 1 #S27386370/M27298481 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SRNZP