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HomeMy WebLinkAboutInsurance Certificate: Applied Control Equipment LLLP Client#: 1089521 APPLICON8 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/22/2022 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(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 USI Cerrtificate Team USI Insurance Services,LLC PHONE ' 800 873-8500 FAX (A/C,No,Ext): (A/C,No): P.O.Box 7050 nDORess: den.certificate@usi.com _ Englewood,CO 80155 INSURER(S)AFFORDING COVERAGE NAIC# 800 873-8500 INSURER A:Travelers Property Cas.Co.of America 25674 INSURED INSURER B:Crum&Forster Specialty Insurance Co. 44520 Applied Control Equipment,LLLP Charter Oak Fire Insurance Company25615 13705 Compark Blvd INSURER C: Englewood,CO 80112 INSURER D 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X Y6300L232307TIL22 07/01/2022 07/01/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR PREMISES(ERENTED nce) $300,000 X BI/PD Ded:10,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 _ GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY X JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 . OTHER: $ C AUTOMOBILE LIABILITY X X BA0L2266752214G 07/01/2022 07/01/2023 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X NON- WNED PROPERTY DAMAGE AUTOS ONLY (Per accident) $ _ $ A X UMBRELLA LIAB X OCCUR X X CUP7S6573002214 07/01/2022 07/01/2023 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DEC X RETENTION$10,000 $ A WORKERS COMPENSATION X UB7S6559332214G 07/01/2022 07/01/2023 X PER OTH- ERAND EMPLOYERS'LIABILITY Y/N STATUTE OFFICEWMEMBER EXCLUDED?ECUTIVE N N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Excess Liabi X X SE0119070 07/01/2022 07/01/2023 $10,000,000 Occurrence $10,000,000 Aggregate Excess over 10M Primary DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Stop Gap for Wyoming is under the Workers Compensation. Leased/Rented Equipment Policy Number Y6300L232307TIL22 Insurer Travelers Property Cas.Co.of America Effective Date 07/01/2022 Expiration Date 07/01/2023 Property at premises other than those owned,leased or regularly operated by the insured $100,000.Policy deductible is$500. (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 ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520-0000 AUTHORIZED REPRESENTATIVE I „a''! ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S36385587/M36383739 CDBBC DESCRIPTIONS (Continued from Page. 1) City of Ashland is an additional insured and insurance is primary and non-contributory per the attached. Waiver of subrogation applies per the attached. SAGITTA 25.3(2016/03) 2 of 2 #S36385587/M36383739 USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING L PO BOX 629035 EL DORADO HILLS CA 95762-9035 CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1849