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HomeMy WebLinkAboutInsurance Certificate: Government Computer Sales Inc • Client#: 1045498 GOVERCOM ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/07/2021 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 NAME: USI Insurance Services LLC PHONE 206-441-6300 FAX No): 610-3624503 (AIC,No,Ext}: 601 Union Street,Suite 1000 WASS: select@usi.com AD Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIL# 206 441-6300 INSURER A:Massachusetts Bay Insurance Company 22306 INSURED INSURER B:Hanover Insurance Company 22292 Government Computer Sales Inc. DBA: INSURER C: MultipleIssuing Hartford-WC Cos 00914 GCSIT; GCSIT Solutions; B2 Networks LLC INSURER D:AXIS Surplus Insurance Company 26620 1654 20th Ave. Seattle,WA 98122 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 ADDLSUBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYY1) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY ZD2A944321 06/01/2021 06/01/2022 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR PREMISES(EaEocccur RENTED $100,000 X WA STOP GAP MED EXP(Any one person) _$10,000 - PERSONAL&ADV INJURY $2,000,000 _ GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY JECT X LOC PRODUCTS-COMP/OP AGG_$INCLUDED _ OTHER: $ A AUTOMOBILE LIABILITY ZD2A944321 06/01/2021 06/01/2022 Ee aBcideD SINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per accident) $35,000 XHired PD $ B X UMBRELLA LIAB X OCCUR UH2D725371 06/01/2021 06/01/2022 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 _ DED RETENTION$ $ C WORKERS COMPENSATION 52WECAA3LGE 08/01/2021 08/01/2022 X I STA OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE �R 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 D E&O - P00100003119504 07/01/2021 06/01/2022 $3M Each Wrongful Act Claims Made& SIR:$50,000 Reported Retro Date:6/25/09 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE:VMWare Health Check,Systems Evaluation,Best Practices Review,and Future State Recommendations. The General Liability policy includes an automatic Additional Insured endorsement that provides Additional Insured status to City of Ashland employees,Ryan Stowasser and Kariann Olson,only when there is a written contract that requires such status,and only with regard to work performed on behalf of the named insured. 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 RREEPRESENTAT�IVE, leil ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S32698424/M32695759 PYBZP This page has been left blank intentionally. USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING , PO BOX 629035 EL DORADO HILLS CA 95762-9035 CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1849