HomeMy WebLinkAboutInsurance Certificate: Metals Treatment Technologies, LLC �► �� CERTIFICATE OF LIABILITY INSURANCE DATE(ASM=DDlYYYY)
913012025
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: It the certificate holder Is an ADDITIONAL INSURED,the policy(les) 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 endorsements .
PRODUCER CComu CT Vella Mancha
Holmes Murphy&Associates PHONE
2727 Grand Prairie Parkway (AJC.N ExW
Ac No:
Waukee IA 50263 ADDRESS: vmancha@holmesmtirphy.com
�� _ _._.._.-- NAICtJ
_,__. �_....__��SURER S AFFORaN4 COVERAGE I
INSURERA: Starr Surplus Lines insurance Company 13604
INSURED MFTTREPC 21784
Metals Treatment Technologies, LLC iNsuAERD: I lremeRs insurance Com a of WA,CJ.C.
14045 West 66th Avenue iNsumiic: Pinnacol Assurance Company m 41190
Arvada, CO 80004 msuneRD:Zurich American Insurance Company 16535
insuRERE:Atlantic Specialty Insurance Company 27154
INSURER F:
COVERAGES CERTIFICATE NUMBER:96673547 REVISION NUMBER:
THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWfTHSTANDING 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.
iNSH - TYPE OF INSURANCE i 1NSD I WVD 1 POLICY MUMMER r rOAUDYYY Y pOLi Y EXp
LTR Y L11117 1YYYY LI?YTS
A X 1 COMMERCIAL GENERALLIAD)UTY I 1000067113251 10/1/2025 1 10/112026 !EACHOCCURRENCE $1,000,000
DAMAGE TO RENTED { _
G CLAIMS-MADE n OCCUR i PR1 hiISE_Sf(EU oCWrtenco)_,..[_S 1D0 DOD
-
X I BIIPD Ded$2,500 ; 3 rtEp EXP(Any one person) $5,DQ0
PERSONAL E:ADV INJURY_ $1,000.000
GFN'L AGGREGATE LIMIT APPLIES PER: i � GENERAL AGGREGATE $2,000,000
X
POLICY[ PRO L ! ' PRODUCTS COMP, S2000,000
`�JEGT ! _S
r—
OTHER; I S
B AUTOMOBILE LIABILITY € CPA328385023 1011l2025 ; 1Dl1l2028 COMBiNED SINGLE LIMIT 51,000.000
tE_.acbdepI) _ ......_...__..._._.
X I ANY AUTO BODILY INJURY{Per person) S
OWNED l SCHEDULED BODILY INJURY(Pei m6dan1) S
!AUTOS ONLY AUTOS
X E HIRED NON04WNED 1 PROPERTYf)AMAGE $
AUTOS ONLY AUTOS ONLY I i_tPer acz.d.pnl -__ ........
E §
A UMBRELLALIAB X OCCUR I 1000337409251 10/l/2025 I W/t/2026 I EACH OCCURRENCE l$8.000,000
X EXCESS UAB CLAILAS MADE ! AGGREGATE 58 000,000
- ._.....- - - .......
DIED X j RETENTIONS !
C WORKERSCOMPENSATION N!A 4226286 10/1/2025 10/1/2026 X I STATUTE CE3RTH
D AND EMPLOYERS'LIABILITY99507
ANYPROPRIETOR,PARTNEPoEXECUTIVE N E ! E.L.EACH ACCIDENT S 1 000 000
YIN
OFFICER,MEMBEREXCLUDED? I _. --_
(Mandatory In NN) E I. DISEASE EA EMPLOYEE $1,000,000
If as,doscr,Ixa under ! ��
DESCRIPTION OF OPERATIONS t>eVvy l E E L.DISEASE-POLICY LIMIT S 1,000,000
B LeassdfRented EWipimn CPA328385023 101112025 '. 10/1/2026 i$1,i700,004 LlInt $1,000 DaductiWe
E Insta+loon Floater ! 79GO359570003 1011/2025 ! 10/1/2026 S250,0W Ltmlt $2,500 DeducbNe
A ! P61ution/ProfessionnI Liab I 1000067113251 1011/2025 I IGIU2026 SIrAd Occr$2Ar1 Agg $2,500 Deducbdle
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (AGORD 101,Add€I€ooat Remarks Schedule,may be anached It mote apace Is reg0ed)
Professional liability Deductible:$15,000 per claim
Project:Ashland Gun Club Trap/Skeet Range As requited 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,per policy terms and conditions.
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, OR ACCORDANCE WITH THE POLICY PROVISIONS.
20 E. Main Street
Ashland OR 97520-0000 AUTHORIZED REISESENTATIVE
USA Vk" C'000"s j,
01908-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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