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HomeMy WebLinkAboutInsurance Certificate: Metals Treatment Technologies LLC Client#: 33569: . METTREPC..: - - _ - - • - -- - - • YYYI� /2020 M/DD/ ACORD�, CERTIFICATE OF LIABILITY INSURANCE 9/30DATE(MM/DD/ 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 Nick Brown Holmes Murphy-Colorado PHONE 720-458-5770 FAX (NC,No,Ext): (A/C,No): 844-248-0468 7600 East Orchard Road,Suite 230 South ADDRESS:_nbrown@holmesmurphy.com Property Casualty-Colorado INSURER(S)AFFORDING COVERAGE NAIL# Greenwood Village,CO 80111 INSURERA:Starr Surplus Lines Insurance Company 13604 INSURED INSURER B:Pinnacol Assurance Company 41190 Metals Treatment Technologies, LLC INSURER c:Zurich American Insurance Company 16535 14045 West 66th Avenue AGCS Marine Insurance Company 22837 Arvada,CO 80004 INSURER D: P Y INSURER E:Starr Indemnity&Liability Company 38318 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. LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYI� (MM/DD/YYYI� A X COMMERCIAL GENERAL LIABILITY X 1000067113201 10/01/2020 10/01/2021 EACH OCCURRENCE $1,000,000 Ep CLAIMS-MADE X OCCUR PREMIEESO(Ea occu o nce) $100,000 X BI/PD 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 X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ • E AUTOMOBILE LIABILITY 1000638063201 10/01/2020 10/01/2021 COMaccideBINEDnt)SINGLE LIMIT $1>000>000 (Ea _ X 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) A UMBRELLA LIAB X OCCUR 1000337409201 10/01/2020 10/01/2021 EACH OCCURRENCE $8,000,000 x EXCESS LIAB CLAIMS-MADE AGGREGATE $8,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION 42262$6 10/01/2020 10/01/2021 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? �/ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 IT yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Workers'Comp-OSC WC298299500 10/01/2020 10/01/2021 $1Mil/1Mi1/$1Mil D L/R Eq/Installat SML93024512 10/01/2020 10/01/2021 $1,000,000; $1,000 Ded A Poll/Prof Liab 1000067113201 10/01/2020 10/01/2021 $1MiI Occ/$2Mil Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is 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 Cityof 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 REPRESENTATIVE I AdAtelei ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD fICA91.149/MR9114fl MA NV1