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HomeMy WebLinkAboutInsurance Certificate: Selectron Technologies IncA� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 01 /29/2024 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 Gillian Baker NAME: M&G Insurance PHONE FAX A/C No Ext : A/C, No): 412 Jefferson Parkway Ste 203 E-MAIL certs@mymgteam.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Lake Oswego OR 97035 INSURERA: Sentinel Insurance Company, Ltd 11000 INSURED INSURER B : Hartford Accident and Indemnity Company 22357 Selectron Technologies, Inc. INSURER C : The Hartford Financial Services Group, Inc 00914 Selectron Enterprise Services LLC INSURER D : 12323 SW 66th Ave INSURER E : Portland OR 97223 INSURER F : COVERAGES CERTIFICATE NUMBER: 24/25 GL BA CYB XS WC 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSLTR TYPE OF INSURANCE AIJIJLbUbK INSD WVD POLICY NUMBER MM/DDY/YYYY MMIDD� LIMITS X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any oneperson) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 A 52SBAR09216 01/31/2024 01/31/2025 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ JPEa LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO B OWNED ASCHEDULED AUTOSONLY UTOS IX 52UECPT5600 01/31/2024 01/31/2025 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED HNON-OWNED AUTOS ONLY AUTOS ONLY Uninsured motorist $ 1,000,000 UMBRELLA LIAB 1,,A OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESSUAe CLAIMS -MADE 52SBAR09216 01/31/2024 01/31/2025 DIED I X RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY POFFICROPRIETOR/PARTNER/EXECUTIVE ❑ In N )EXCLUDED? (Mandatory in NH) (Mandatory N/A 52VVBCGI3039 01/31/2024 01/31/2025 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - FA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Media Liability -claims made 52SBAR09216 01/31/2024 01/31/2025 Each wrongful act Aggregate limit 2,000,000 2,000,000 retro date: 1/14/2014 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 cf " ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC40 114.�� AGENCY CUSTOMER ID: 00162567 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY M&G Insurance NAMED INSURED Selectron Technologies, Inc. Selectron Enterprise POLICY NUMBER CARRIER 7-1C CODE EFFECTIVE DATE: ADDITIONAL REMARKS ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes DATA BREACH COVERAGE Sentinel Insurance Company 1/31/2024 - 1/31/2025 policy #52SBARO9216 Claims made Data Breach - response expenses $500,000 Data Breach - defense and liability $500,000 retro date: 1 /31 /2014 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 52 SBA R09216 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION THE CITY OF ATLANTA 68 MITCHELL ST ATLANTA, GA 30303 CITY OF AMARILLO ATTN: PURCHASING DEPARTMENT P 0 BOX 1971 AMARILLO, TX 79135 CITY OF NOVATO 75 ROWLAND WAY # 2 0 0 NOVATO, CA 94945-5054 CITY OF OCEANSIDE 300 NORTH COAST HWY OCEANSIDE, CA 92054 CITY OF PORTLAND 1120 SW 5TH AVE ROOM 750 PORTLAND, OR 97204 CITY OF SANTA ANA RISK MANAGEMENT DIVISION, 4TH FLOOR 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 COUNTY OF PLACER C/O EBIX BPO P 0 BOX 257 PORTLAND, MI 48875 FULTON COUNTY GOVERNMENT DEPARTMENT OF PURCHASING & CONTRACT COMPLIANCE 130 PEACHTREE STREET SW. SUITE 1168 ATLANTA, GA 30303-3459 PLACER COUNTY WATER AGENCY P 0 BOX 6570 AUBURN, CA 95604 Form IH 12 00 11 85 T SEQ. NO. 003 Printed in U.S.A. Page 001 (CONTINUED ON NEXT PAGE) Process Date: 01/08/24 Expiration Date: 01/31/25 POLICY NUMBER: 52 SBA R09216 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION THE CITY OF ELK GROVE ITS OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS PO BOX 20270 LONG BEACH CA 90801 CITY OF DETROIT PURCHASING DIVISION COLEMAN A YOUNG MUNICIPAL CENTER SUITE 1008 DETROIT, MI 48226 CITY OF FRESNO C/O ISD 2600 FRESNO ST., ROOM 1059 FRESNO, CA 93721 CITY OF ASHLAND 20 EAST MAIN STREET ASHLAND, OR 97520 Form IH 12 00 11 85 T SEQ. NO. 003 Printed in U.S.A. Page 002 (CONTINUED ON NEXT PAGE) Process Date: 01/08/24 Expiration Date: 01/31/25