HomeMy WebLinkAboutInsurance Certificate: Advanced Media TechnolgiesACORO
® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
01/0312024
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
MARSH USA, LLC.
1166 Avenue of the Americas
CONTACT
NAME:
PWC.HONNo,EExtim aC No):
E-MAIL
ADDRESS:
New York, NY 10036
INSURERS AFFORDING COVERAGE
NAIC 0
INSURER A : Tokio Marine America Insurance Company
10945
CN102238245-AMT-Prof-23-25
INSURED
Advanced Media Technolgies
INSURER B: Mitsui Sumitomo Insurance Company Of America
20362
INSURER C : N/A
N/A
3150 SW 15th Street
INSURER D
Deerfield Beach, FL 33442
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: NYC-011840573-04 REVISION NUMBER: 4
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTVVITHSTAN DING 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.
ILLICY
TR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
POLICY EFF
MM DD/YYYY
EXP
i
MIDD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
X
CLL6403455-13
06/30/2023
06/30/2024
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTE
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY JE LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
$ 1,000,000
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
X
BVR8302197
01/01/2024
01/01/2025
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
_
$
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
X
UMBRELLA UAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
X
CU6406757-10
06/30/2023
06/30/2024
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
DED I X I RETENTION $1O 00O
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBEREXCLUDED? ❑N
(Mandatoryin NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WCP9108740
011 1/2 25
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required)
City of Ashland, Oregon, and its elected officials, officers, and employees are included as additional insured where required by written contract with respect to General Liability and Auto Liability.
laK I It-16A I t FIULUtK
City of Ashland
20 East Main St
Ashland, OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
0002469 SP 0005-001-P02470-1
City of Ashland
20 East Main St
Ashland, OR 97520
0005-01-00-0002469-0001-0006058
19 .
00 Marsh
Dear Certificate Holder:
To streamline certificate delivery for our clients and in an effort to support our firm's commitment to
sustainability, going forward, we will only be providing renewal certificates of insurance electronically.
If you need to continue receiving a copy of the attached certificate, please send an email to
USOperations.email@marsh.com and include the following:
-- Certificate # (Shown below Insured Name — e.g., ABC-123456789-01)
-- E-Mail for future delivery
For your convenience, If we do not receive your response, we will conclude that you no longer require proof of
insurance from the named insured and will remove you from our records.
Thank you,
US Operations, Marsh USA, LLC
0005-01-00-0002469-0002-0006059
a