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HomeMy WebLinkAboutInsurance Certificate: Selectron Technologies, Inc.A� Q® CERTIFICATE OF LIABILITY INSURANCE DD/YY DATE(MM1/2025YY) 01/23/2025 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 FTHIS 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 PHONEo FAX AIC NExt C, No E-MAIL certs@mymgteam.com ADDRESS: 7150 SW Hampton St. INSURER(S) AFFORDING COVERAGE NAIC # Suite 140 INSURERA: Sentinel Insurance Company, Ltd 11000 Tigard OR 97223 INSURED INSURER B : Hartford Accident and Indemnity Company 22357 INSURER c : The Hartford Rated by Multiple Companies 00914 Selectron Technologies, Inc. INSURER D: Selectron Enterprise Services LLC INSURER E : 13535 SW 72nd Ave, Ste 200 INSURER F: Portland OR 97223 COVERAGES CERTIFICATE NUMBER: 25/26 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 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DPOLIDY/YYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE Fx_1 OCCUR DAMAGE TO RENI 75 PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 A 52SBAAF5779 01/31/2025 01/31/2026 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ODUCTS-COMP/OP AGG 2,000,000 $ POLICY ❑PRO ❑LOC JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANYAUTO BODILY INJURY (Per accident) $ B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 52UECPT5600 01/31/2025 01/31/2026 PROPERTY DAMAGE Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE 52SBAAF5779 01/31/2025 01/31/2026 AGGREGATE $ 5,000,000 DED I X1 RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 52WBCGI3039 01/31/2025 01/31/2026 X1 STATUTE EOTH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below Each wrongful act 1,000,000 A Professional Liability,Data Privacy, Network Security Liability - claims made 52SBAAF5779 01/31/2025 01/31/2026 Aggregate limit 2,000,000 retro date 1/14/2014 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER 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 (Vltlt$tf-ZUIOAL.UKL)t,UKVUKAIIUN. All rlgniS reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 52 SBA AF5779 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 #200 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 Process Date: 01/13/25 Expiration Date: 01/31/26 POLICY NUMBER: 52 SBA AF5779 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 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 Process Date: 01/13/25 Expiration Date: 01/31/26 ACOR" 41..� AGENCY CUSTOMER ID: 00162567 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY M&G Insurance NAMED INSURED Selectron Technologies, Inc. Selectron Enterprise POLICY NU MBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS 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 Ltd 1/31/2025 - 1/31/2026 policy #52SBAAF5779 Claims made Data Breach - response expenses $500,000 Data Breach - defense and liability $500,000 retro date: 1 /31 /2014 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds Selectron Payment Services LLC STC2 Inc OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC „a POLICY INSURER LIST BY JURISDICTION INSURER NAIC JURISDICTION Hartford Fire Insurance Company 19682 NC NV ONE HARTFORD PLAZA HARTFORD CT 06155 Trumbull Insurance Company 27120 TX ONE HARTFORD PLAZA HARTFORD CT 06155 Hartford Casualty Insurance Company 29424 WI FL ONE HARTFORD PLAZA HARTFORD CT 06155 Twin City Fire Insurance Company 29459 IN OR WA OK ONE HARTFORD PLAZA HARTFORD CT 06155 Hartford Insurance Company of the Midwest 37478 NY ONE HARTFORD PLAZA HARTFORD CT 06155 Hartford Insurance Company of Illinois 38288 IL ONE HARTFORD PLAZA HARTFORD CT 06155 THE COVERAGE PROVIDED IN EACH JURISDICTION IS WITH RESPECT TO THE LOCATIONS OF THE NAMED INSURED IN THAT JURISDICTION IN ACCORDANCE WITH THE WORKERS' COMPENSATION LAW OF THAT JURISDICTION. AS USED IN THIS POLICY, "COMPANY”, "WE", "US" AND "OURS" MEAN THE MEMBER INSURANCE COMPANIES OF THE HARTFORD INSURANCE GROUP COLLECTIVELY PROVIDING THIS INSURANCE. Nothing herein, contained shall be held to vary, waive, alter or extend any of the terms, conditions, agreements or information of the policy, other than as herein stated. Form WC 66 04 40 Printed in U.S.A. Process Date: 12/22/24 Policy Expiration Date: 01/31/26