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HomeMy WebLinkAboutInsurance Certificate: UNAVCOA`CORL�� DATE (MM D0 "YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/2512019 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 g y g Nathan Kathol NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX 6300 South Syracuse Wa Suite 700 • 303-889-2548 a_C.No:720-200-5127 E-MAIL Centennial CO 80111 ADDRESS: Nathan_Kathol a'19 com INSURER(S) AFFORDING COVERAGE _ NAIC INSURER A : Federal Insurance ComDanV ! 20281 INSURED INSURER B : UNAVCOInc. _ — - —_- 6350 Nautilus Drive INSURERC.: Boulder, CO 80301 INSURER0: . rnVFRAr.FR rFRTIFICATF NIIMRFR- 55A0R77gn 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 ADOL SUBR POLICY EFF-_POLICY EXP LIMITS LTR :I WVD' POLICY NUMBER MM,'DD'YYY � MM;DDlYYY - A X COMMERCIAL GENERAL LIABILITY I 135988128 11/1/2019 11/1/2020 EACH OCCURRENCE f $1,000,000 CLAIMS -MADE x OCCUR DAMAG TOFIENTED PREMISEa occirrenceZ, $1,000,000 $ 5.I)AO MED EXP (Any one person) PERSONAL 8 ADV INJURY _ $ 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 i R. X POLICY! i JECT LOG I PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER A AUTOMOBILE LIABILITY 73581997 11/1/2019 11/1/2020 COMBINED SINGLE LIMIT $1,000,000 $ X I ANY AUTO BODILY INJURY (Per person) i OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) PROPERTY DAMAGE (Per. accidentl __�_ $ $ —._--_ A X UMBRELLA LIAB X OCCUR i EXCESS LIAB _ _CLAIMS -MADE_ 78191524 11/1/2019 11/1/2020 EACHOCCURRENCE AGGREGATE $2,000.000 $2,000,000 $ DEC X RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETORPARTNER'EXECUTIVE OFFICERrMEMBEREXCLUDED' (Mandatory In NH) MIA j R I [� STATUTE ER E.L. EACH ACCIDENT E1. DISEASE • EA EMPLOYEE $ $ E.L. DISEASE - POLICY LIMIT $ I It yes, describe under DESCRIPTION OF OPERATIONS bebw I I I DESCRIPTION OF OPERATIONS i LOCATIONS, 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 terms and conditions CERTIFICATE HOLDER CANCELLATION City of Ashland, Oregon an Oregon Municipal Corp. 20 E. Main Street Ashland OR 97520 USA 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 PRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 2 5762 2 of 2 5762