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HomeMy WebLinkAboutInsurance Certificate: Metals Treatment Technologies, LLC P5260028002 • ACCARb0 DATE IYYYY) .—• CERTIFICATE OF LIABILITY INSURANCE 09/19/209/2023 40...•• 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 1114 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED m REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. w IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. ' m 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 Ileu of such endorsement(s). PRODUCER 1-844-484-7750 CONTACT Vella Mancha N. Holmes Murphy & Associates - CO PHONE FAX M (NC.No.Extl: (AIC.No): (V E-MAIL vmancha@holmesmurphy.com 7600 East Orchard Road, Suite 230 South ADDREss: INSURER(S)AFFORDING COVERAGE NAIC# Greenwood Village, CO 80111 INSURERA: STARR SURPLUS LINES INS CO 13604 INSURED INSURER B: FIREMENS INS CO OF WASHINGTON DC 21784 Metals Treatment Technologies, LLC INSURER C: PINNACOL ASSUR 41190 14045 West 66th Avenue INSURERD: ZURICH AMER INS CO 16535 INSURER E:ATLANTIC SPECIALTY INS CO 27154 Arvada, CO 80004 INSURERF: COVERAGES CERTIFICATE NUMBER:69675970 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: ILTR TYPE OF INSURANCE ADOL SUER POLICY EFF POLICY EXP LIMBS MMD WVD; POLICYNUMBER (MMIODIYYYY) (MMIDDIYYYY) A X COMMERCIALGENERALLIABILITY 1000067113231 10/01/23 10/01/24 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I X I OCCUR PAGE TO RENTED REM SES(Ea occurrence) $ 100,000 • X was Ded: $2,500 MED EXP(Any one person) _$ 5,000 _ ' PERSONAL&ADV INJURY $ 1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I_J 12 I I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILELIABILITY CPA328385023 10/01/23 10/01/24 COMBINED SINGLE LIMIT $ 1,000,000 . (Ea accident) - X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIREDX NON-OWNED PROPERTY DAMAGE $ " AUTOS ONLY _AUTOS ONLY •- (Per accident) _ $ A UMBRELLALIAB X OCCUR 1000337409231 10/01/23 10/01/24 EACHOCCURRENCE $ 8,000,000 X EXCESSLIAB CLAIMS-MADE AGGREGATE $ 8,000,000 DED X RETENTION$ 0 $ C WORKER5COMPENSATION 4226286 10/01/23 10/01/24 X PER 0T AND EMPLOYERS'LIABILITY D ANYPROPRIETOR/PARTNER/EXECUTIVE E NIA WC29829950501 10/01/23 10/01/24 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED7 (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 $ E Installation Floater 79003$9570001 10/01/23 10/01/24 $1,000,000 Limit 2,500Ded B Leased/Rented Equipment CPA328385023. 10/01/23 10/01/24 $1,000,000 Limit 1,000Ded A Pollution/Professional Liab. 1000067113231 10/01/23 10/01/24 $1.1411 Occ/$2Mil Ag 2,500Ded DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace Ia required) Project: Ashland Gun Club Trap/Skeet Range As required by written contract or written agreement, the City of Ashland, Oregon, and its elected officials, officers and employees are included as Additional Insured under General Liability and Automobile Liability on a primary and non-contributory basis with respect to the above referenced. . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE .DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main Street AUTHORIZEDREPRESENTATIVE Ashland, OR 97520-0000 al 71/�"" I USA • ©1988-2015 ACORD CORPORATION. All rights reserved. . ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD. VMancha 69675970 P5260028002 `a 0 N SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 09/19/2023 • NAME OF INSURED: Metals Treatment Technologies, LLC OG M .O M en M • • • • • • • • • • • • • • • SUPP(10/00) PCOVERFORM Holmes Murphy&Associates CO 7600 East Orchard Road;Suite 230 South• Greenwood Village,CO 80111 202309203305 • Electronic Service Requested MIXED AADC 975 23565 0.7648 MB 0.558 IiilliiIII,IIIIIuIiiiiIIriInillih.i.i.IlinuiuiuIIinIuIuiuI City of Ashland 331 51 WINBURN WAY ASHLAND, OR 97520-2735 P5260028002 g Holmes Murphy&Associates-CO IA 7600 East Orchard Road,Suite 230 South Greenwood Village,CO 80111 Electronic Service Requested EBIX I X B p O M C /� r o MIXED AADC 975 23565 0.7648 MB 0.558 IIIiIIIIyIIIII"IIIIIIIiIuIIlllrl'IIIIiII1111iulllll'1'III'lu City of Ashland 331 cMv 20 E MAIN ST ASHLAND, OR 97520-1814 This document was brought to you by Certificateallow. - If you have questions regarding the content of this document, please contact Holmes, Murphy - & Associates, LLC or the Insured listed on the certificate of insurance or the Insured - listed on the notice of cancellation/reinstatement.- cc: - The data included in this notice and.in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. 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