HomeMy WebLinkAboutInsurance Certificate: Day Wireless Systems (2)
A CORDN CERTIFICATE OF LIABILITY INSURANCE DATE (MMJODNYYY)
10/1/2009
PRODUCER (503)241-0625 FAX: (503)221-0540 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Durham and Bates Agencies Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
720 SW Washington ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Sui te 250
Portland OR 97205-3554 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: See Below For Vrs Coso 37478
Day Management Corporation lNSURER B:
DBA: nay Wireless Systems INSURER c.
4700 SE International Way INSURER D:
Milwaukie OR 97222 INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIIVJTHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VIJITH 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.
AGGRF(.~ATF liMITS .c::HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR AOO'L P~A~~~~~gg;WE PgiW/~~~rAAN LIMITS
I lYPE OF INSURANCE POLICY NUMBER
~NERAL L1ABILllY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY ~~&~JOE~~~n~l $
[ CLAIMS MADE D OCCUR MEO EXP {Anv one ""'rson' $
PERSONAL & AOV INJURY $
GENERAL AGGREGATE $
~.~ AGG~EnEILlMIT AnE~ PER PRODUCTS - COMP/OP AGG $
PRO- .
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Eaaccidenl)
- ANY AUTO
- ALL OIlVNED AUTOS BODILY INJURY
{Per person) $
SCHEDULED AUTOS
- ['I]" - ' m
HIRED AUTOS " , , f] \i:,ji I,=,
- ' , BODILY INJURY
(Peraccidenl) $
NON-O\^INED AUTOS -- .
- - - -, 1
if PROPERTY DAMAGE $
I1(,T 7 '1nr,n (Peraccidenl)
U Uj ~ ~. '-vvoJ I I',
GARAGE L1ABILllY AUTO QNL Y - EA ACCIDENT $
=1 ANY AUTO -' OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY $
~ OCCUR D CLAIMS MADE '.
AGGREGATE $
$
=1 ~EOUCTISLE $
RETENTION $ --- - ,
A WORKERS COMPENSATION AND 52WELN9641 10/1/2009 10/1/2010 X I T~$nrJ}?<-1 I01~'
EMPLOYERS' L1ABILllY 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE OR-Hartford of MidWest E.L EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? CA-Hartford Acciden t Ind E.L DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under Casualty 1,000,000
SPECIAL PROVISIONS 0010'# NY-Hartford E.L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Evidence of insurance provided subject to the terms, conditions, limitations and exclusions of the policy. *Except 10
days notice for non-payment of premium.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF ASHLAND EXPIRATION DATE THEREOF, THE ISSUING INSURER I'IlLL ENDEAVOR TO MAIL
20 EAST MAIN STREET 30. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT
ASHLAND, OR 97520 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ..--:::>
Joanna Brown/MJK <::..... \ ~
ACORD 25 (2001/08)
INS025 (010S)08a
@ ACORD CORPORATION 1988
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ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMiDOIYYYY)
10/1/2009
PRODUCER (503)241-0625 FAX: (503)221-0540 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Durham and Bates Agencies Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
720 sw Washington ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 250
Portland OR 97205-3554 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: See Below For Vrs Coso 37478
Day Management Corporation INSURER B"
DBA: Day Wireless Systems INSURER c:
4700 SE International Way INSURER 0:
Milwaukie OR 97222 INSURER E"
COVER G
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 RESPECTTO 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.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ~~~~ P6'}+~~J~~gg;W~ Pg~lfll~~~~N LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER
~NERAL LIABILITY EACH nrCURRENCE ,
COMMERCIAL GENERAL LIABIUTY ~~~~J9E~~~~nce' ,
l CLAIMS MADE D OCCUR MED EXP IAn"one "erson' ,
e- PERSONAL & ADV INJURY ,
e- GENERAL AGGREGATE ,
~'L AGG:EnE LIMIT AnES PER: PRODUCTS - COMP/OP AGG ,
PRO-
POLICY JECT LOC
~TOMOBJLE LIABILITY COMBINED SINGLE LIMIT ,
ANY AUTO (EaaccldenJ)
-
- ALL OWNED AUTOS BODILY INJURY
{per person) ,
- SCHEDULED AUTOS
- HIRED AUTOS BODILY INJURY ,
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE ,
(Per accident)
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT ,
ANY AUTO OTHER THAN EA ACC ,
AUTO ONLY; AGG ,
~ESSfUMBRElLA LIABILITY "'^"U "'''''' 'oo"'N"E ,
OCCUR D CLAIMS MADE AGGREGATE ,
~ DEDUCTISLE ,
,
RETENTION $ ,
A WORKERS COMPENSATION AND 52WELN9641 10/1/2009 10/1/2010 X I T~,,9!fJN-s I IOTH-
ER
EMPLOYERS' LIABILITY 1,000,000
ANY PROPRJETOR/PARTNERlEXECUTIVE OR-Hartford of MidWest E.L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? CA-Hartford Acc~dent Ind E.L. DISEASE. EA EMPLOYEE $ 1,000,000
II yes, describe under NV-Hartford Casualtv 1,000,000
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDEO BY ENDORSEMENT/SPECIAL PROVISIONS
Evidence of insurance provided subject to the terms, conditions, limitat~ons and exclusions of the policy. *Except 10
days notice for non~payment of pre~um.
, CITY RECORDER
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
ASHLAND FIRE DEPT EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
ATTN: CHIEF WOODLEY 30' DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
455 SISKIYOU BLVD. FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR ~IABILtTY OF ANY KIND UPON THE
ASHLAND, OR 97520
INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ..---:>
Joanna Brown/MJK <::-. \ ~
ACORD 25 (2001108)
INS025 (0108).08a
@ACORD CORPORATION 1988
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