HomeMy WebLinkAboutInsurance Certificate: D2000 Safety Inc ® DATE(MM/DD/YYYY)
ARD® CERTIFICATE OF LIABILITY INSURANCE 08MM/DD23
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 Jennifer Stuve .
NAME:
PBC Insurance (a/c°NN ): (541)484-6624 FAX
No): (541)686-2726
450 Country Club Road#330E-MAIL jstuve@pbcins.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Eugene • OR 97401INSURERA: Crum&Forster Specialty Insurance Company 44520
•INSURED INSURER B Rated by Multiple Companies 00914
D2000 Safety Inc • INSURER C:
P O BOX 2939 INSURER D:
INSURER E:
Eugene . . OR 97402 INSURER F
COVERAGESCERTIFICATE NUMBER: ' 23-24GL,Auto,Prof 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 BR POLICY EFF •POLICY EXP
LTR TYPE OF INSURANCE' INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS
X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED 50,000
CLAIMS-MADE X OCCUR - PREMISES(Ea occurrence) • $
• • MED EXP(Any one person) $ 5,000
A ^ . Y Y EPK-144703 08/01/2023 08/01/2024- PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATELIMIT APPLIES.PER: ' . • GENERAL AGGREGATE $ 2,000,000
POLICY n PE� n LOC 2,000,000
PRODUCTS-COMP/OPAGG $
OTHER: •
Professional Liability $ 1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
• • (Ea accident)
' ANY AUTO - BODILY INJURY(Per person) $ 1,000,000
A OWNED SCHEDULED • EPK-144703 08/01/2023 08/01/2024 BODILY INJURY(Per accident) $ 1,000,000
AUTOS ONLY .AUTOS •
XHIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY X AUTOS ONLY (Per accident)
$
UMBRELLA UAB . OCCUR EACH OCCURRENCE $
EXCESS LIAR ^ CLAIMS-MADE AGGREGATE $
DED RETENTION$ • $
WORKERS COMPENSATION X SEATUTE 0TH
AND EMPLOYERS'LIABILITY y I N
ER
B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 52WECHO3368 03/10/2023 03/10/2024 E.L.EACH ACCIDENT $ 1,000,000 .
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) - E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below . . -- , E.L.DISEASE,-POLICY LIMIT $
Each Wrongful Act 3,000,000
Professional Liability
A Pollution Liability EPK-144703 08/01/2023 08/01/2024 Each Wrongful Act 1,000,000
. Deductible 5,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
City of Boise,is listed,as Additional Insured per written contract and policy conditions.
•
CERTIFICATE00 .
DE • CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Ashland • • ACCORDANCE WITH THE POLICY PROVISIONS.
•
20 East Main Street
AUTHORIZED REPRESENTATIVE'
Asland . OR 97520 ��
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