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HomeMy WebLinkAboutInsurance Certificate: Industrial Software Solutions _____—.....41 INDUS-5 OP ID: 1N ACORLY CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/1112019 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 206-956-1600 CONTACT Nanci Gonzalez Brown&Brown of WA.Inc.(B) NAME:ON 800 Fifth Ave Suite 2400 (AH/co,No,Ext):206-956-1600 I FAX No):206-956-9600 Seattle,WA 98104 EMAIL ngonzalez@bbseattle.com Brown&Brown of WA ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Property&Casualty 25674 INSURED Industrial Software Solutions INSURER B:TRAVELERS INDEMNITY CO OF CT 25682 19909 120th Ave NE#101 Travelers Indemnity Company 25658 Bothell,WA 98011 INSURER C: `7 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF' POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ZLP-14T51135 12/01/2019 12/01/2020 DAMAGE TO RENTED 300,000 Y PREMISES(_Ea occurrence) $ • MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- LOC2,000,000 PRO- JECT PRODUCTS-COMP/OPAGG $ OTHER: $ C AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ _ ANY AUTO Y BA1 L109801 12/01/2019 12/01/2020 BODILY INJURY(Per person) _$_ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS ONLY (Peer accidentDAMAGE $ • $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE CUP-2L19643A 12/01/2019 12/01/2020 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 5 B WORKERS COMPENSATION PER X 0TH- - - AND EMPLOYERS'LIABILITY - -Y/N UB6828M066 10/15/2019 10/15/2020 STATUTE ER__ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A WA STOP GAP (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 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Avenue - Ashland,OR 97520 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD