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HomeMy WebLinkAboutInsurance Certificate: D2000 Safety Inc " ® DATE(MM/DDIYYY1� A��o CERTIFICATE OF LIABILITY INSURANCE 07/26/2021 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jennifer Stuve NAME: PBC Insurance PHONE ,Ext): (541)484-6624 {AIDC,No): (541)686-2726 (AI450 Country Club Road#330 E-MAIL jstuve@pbcins.com ADDRESS: INSURER(S)AFFORDING COVERAGE'. NAIC# Eugene OR 97401 •INSURER A; Crum&Forster Specialty Ins Co INSUREDINSURER B: Rated by Multiple Companies 00914 •D2000 Safety Inc INSURER C: P 0 Box 2939 INSURER D: INSURER E: Eugene OR 97402 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2172639898 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 INSD WVD POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREM SES(Ea occu ence) $ 50,000 MED EXP(Any one person) $ 5,000 A Y Y EPK-136338 08/01/2021 08/01/2022 PERSONAL BADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE $ 2,000,000 PRO POLICY LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT _ _ ' OTHER: Professional Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED EPK-136338 08/01/2021 08/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /_� AUTOS ONLY (Per accident) $ UMBRELLA UABOCCUR EACH OCCURRENCE $ _ EXCESS LIAB• CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? N/A 52WECH03368 03/10/2021 03/10/2022 (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE $ 1,000,000 If yes,describe under 1'00'0 0 00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • Each Wrongful Act ' 3,000,000 Professional Liability A EP K-136338 08/01/2021 08/01/2022 Deductible 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS f 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. , CERTIFICATE HOLDER 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 I 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD