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HomeMy WebLinkAboutInsurance Certificate: Applied Control Equipment, LLLPClient#: 1089521 APPLICON8 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 7/02/2024 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services, LLC 4600 S. Ulster Street, Suite 1200 Denver, CO 80237 800 873-8500 CONTACT USI Certificate Team PHONE 800 873-8500 FAX A/C, No, Ext : (A/C, No): E-MAIL ADDRESS: den.certificate@usi.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Insurance Co of LA 32298 INSURED Applied Control Equipment, LLLP 13705 Compark Blvd. Englewood, CO 80112 INSURER B : Travelers Property Cas. Co. of America 25674 Westfield Specialty Insurance Company INSURER C: p Y P y 16992 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 CONTRACTOR 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 ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X GL6952534 07/01/2024 03/01/2025 EACHOCCURRENCE $1,000,000 CLAIMS -MADE [* OCCUR PREMI6ESOEaoNcurrDence $300,000 MED EXP (Any one person) $25,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO - POLICY X JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY X X AL4629129 07/01/2024 03/01/202 EeaBc,denSINGLELIMIT $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY B X UMBRELLA LAB X OCCUR X X CUP5Y17249324NF 07/01/2024 03/01/2025 EACH OCCURRENCE $5 OOO 000 AGGREGATE s5,000,000 EXCESS LAB CLAIMS -MADE DED I X RETENTION $1 O 000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N / A X WC80771595 07/01/2024 03/01/2025 X STATUTE EERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 C Excess Liab over X X XSL424114HOO 07/01/2024 03/01/202 5M Occur/5M Aggregate 5M Primary Umb DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Stop Gap for Wyoming is under the Workers Compensation. City of Ashland is an additional insured and insurance is primary and non-contributory per the attached. Waiver of subrogation applies per the attached. CERTIFICATE HOLDER CANCELLATION City of Ashland 20 E Main Ashland, OR 97520-0000 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 ACORD 25 (2016/03) 1 of 1 #S45395697/M45324719 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AEBZP This page has been left blank intentionally.