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HomeMy WebLinkAboutInsurance Certificate: Olsson Industrial Electric Inc dba OS Engineering NAESCOR-02 LWANG2 • ACORO" ' DATE(MM/DD/YYYY) `� • CERTIFICATE OF LIABILITY INSURANCE 5M8/2022 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 rights to the certificate holder in lieu of such endorsement(s)., PRODUCER ' CONTACT Certificate Requests NAME: . Alllant Insurance Services,Inc. PHONE • FAX• 10 Almaden Boulevard,Suite 650 (A/c,No,Ext):(408)352-6700 : (A/C,No): . . San Jose,CA 95113 - - _ ESs sjcertificates@alliant.com • - INSURER(S)AFFORDING COVERAGE NAIC# - INSURER A:Zurich American Insurance Company 16535 • INSURED INSURER B:American Zurich Insurance Company-. 40142 Olsson Industrial Electric,Inc.dba OS Engineering - INSURER C:Berkley Assurance Company. 39462 - 1180 NW Maple Street,Suite 200 INSURER D: . : • Issaquah,WA 98027 - . - . INSURER E: . • . 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 ' 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 ADDL SUBR - -- I POLICY EFF POLICY EXP . - LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMMIDD/YYYY) (MMIDD/YYYY) - LIMITS • A XI COMMERCIAL GENERAL LIABILITY- • EACH OCCURRENCE 2,000,000 CLAIMS-MADE X OCCUR GLO 5574116-09 5/20/2022 5/20/2023 DAMAGE TO RENTED, 1,000,000 • X �EMISES�Eagccunence) $ . ' MED EXP(Any one person) $ Included PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATELIMIT APPLIESPER: - - . . GENERAL AGGREGATE $ 4,000,000 POLICY X Fla LOC PRODUCTS-COMP/OP AGG- $ 4,000,000 OTHER: • • $ A AUTOMOBILE LIABILITY Es COMBINED SINGLE LIMIT $ 2,000,000 X ANY AUTO • X BAP 9830191-12 5/20/2022 5/20/2023 BODILY INJURY(Per person) $ ' OWNED SCHEDULED AUTOS ONLY - AUTOS BODILY INJURY(Per accident) $ pPOPRTYAMAGE AUTOS ONLY NON-OWNED ONLY $ ' Comp/Coll Ded $ 5,000 UMBRELLA LIAB _ OCCUR EACH OCCURRENCE _$ • EXCESS LIAB CLAIMS-MADE AGGREGATE _ ' - . DED RETENTION$ . $ B WORKERS COMPENSATION X•ISTATUTE ETH_ AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC 5574117-09 5/20/2022 5/20/2023 E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) • E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under • 2,000,000 • -DESCRIPTION OF OPERATIONS below • - • E.L.DISEASE-POLICY-LIMIT -$ C PROFESSIONAL& PCAB-5018181-0522 5/20/2022 5/20/2023 Each Act/Incident 5,000,000 C POLLUTION LIABILITY -. - - - PCAB-5018181-0522 1 5/20/2022 5/20/2023 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) The City of Ashland,Oregon and its elected officials,officers and employees are incuded as additional insured where required by written contract and allowed by law with respect to General Liability and Automobile Liability.This insurance shall be primary and non-contributory and limited to liability arising out of the operations of the named insured when required by written contract,with respect to General Liability,Automobile Liability,and Umbrella Liability. CERTIFICATE HOLDER- - - CANCELLATION • 1 • . 1 • . - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Ashland • THE EXPIRATION- DATE THEREOF, NOTICE WILL BE DELIVERED, IN City ACCORDANCE WITH THE POLICY PROVISIONS. 20 East MainStreet • - - - . Ashland,OR 97520 '- AUTHORIZED REPRESENTATIVE • ACORD 25(2016/03) - ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD-