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Home My WebLink AboutInsurance Certificate: Engineered Monitoring Solutions (2) ~ ACORD". CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDfYYYYj ~ 12/10/2009 PRODUCER (503)624-0466 FAX: (503)624-0846 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Slater & Associates Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 1469 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tualatin OR 97062-1469 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: SAIF Corp 36196 INSURER B: Engineered Monitoring Solutions LLC INSURER c: 617 N Main St INSURER 0: Newb~rg OR 97132 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY 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, AGGREGATE LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1~~:Aur;~~ TVD< n< , POLICY NUMBER ~~~CY EFFECTIVE POLICY EXPIRATION LIMITS ~NERAl LIABILITY ~~~I! q~cU~~_~_NC_~ . DAMAGE TO RENTED - COMMERCIAL GENERAL LIABILITY PREMISES lEa occurrence) . - ~ CLAIMS MADE D OCCUR MEO EXP (Anyone person) . - PERSONAL & ADV INJURY . - GENERAL AGGREGATE . ~'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG . POLICY n \~9-; n LOC I ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT . ANY AUTO (Ea accidant) - - ALL OWNED AUTOS BODILY INJURY (Per person} . - SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY . NON-OWNED AUTOS (Peraccidenl) - - PROPERTY DAMAGE . (Peraccidenl) RRAGE UABILlTY AUTO ONLY - EA ACCIDENT . ANY AUTO OTHER THAN EA ACC . AUTO ONLY: AGG I . ~ESS f UMBRELLA LIABILITY EACH OCCURRENCE I. OCCUR 0 CLAIMS MADE AGGREGATE . =1 DEDUCTIBLE . -_._------ ---._-~-- -~-----_._-~ I RETENTION . I . A WORKERS COMPENSATION ~T~C STAT#~ I IOJ,t'. AND EMPLOYERS' LIABILITY VIN TOR'LUMJ ANY PROPRIETORlPARTNERIEXECUTIVE D E.L EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? I (Mandatory In NH) 958900 12/1/2009 12/1/2010 E.L DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under E.L DISEASE - POLICY LIMIT I $ 500 ODD SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS f LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS CITY RECORDER CERTIFICATE HOLDER CANCELLATION (541)488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF ASHLAND DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN 90 N Mountain Ave NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Ashland, OR 97520 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ ----r-!A.dOY Dee Tudor/OMT A. ACORD 25 (2009/01) INS025 (200901) 1 @ 1938-2009 ACORD CORPORATION. All rights reBerved. The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYV) TM. 12/08/2009 PRODUCER Phone: 503-365-7001 Fax: 503-365-7354 THIS CERllFICA TE IS ISSUED AS A MATTER OF INFQRMA 1l0N MID VALLEY GENERAL AGENCY LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4305 RIVER ROAD N ~~~:~~'S CERTIFICATE OOES ~.;';t<M~~~,~~~~, I~R KEIZER OR 97303 ", f INSURERS AFFORDING COVERAGE NAIC# ,.. INSURED INSURER A: SCOTTSDALE INSURANCE COMPANY 41297 ENGINEERED MONITORING SOLUTIONS LLC INSURER B: 617 N MAIN ST Y INSURER C: NEWBERG OR 97132 INSURER D: INSURER E: COVERAGES 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 VvlTH 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. AGGREGATE LIMITS SHOW>J MAY HAVE BEEN REDUCED BY PAID CLAIMS. ; INSR "'" TYPE OF INSURANCE POLICY NUMBER rogA~~~~~ ~;:r~~N LIMITS em 'N'" GENERAL LIABILITY CPSll04202 12/03/09 12/03/10 EACH OCCURRENCE $ 1,000,000 ~ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 PREl.lISES(EIO<X>.IIenee) I CLAIMS MADE [!] OCCUR MED. EXP (Anyone person) $ 5,000 A PERSONAL & ADV INJURY $ 1,000,000 - (;EN'l AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 , POLICY n j:& n Lac PRODUCTS-COMPIOP AGG $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (EaaCCident) $ ANY AUTO - ALL OWNED AUTOS BODILY INJURY - (Per person) $ SCHEDULED AUTOS _. - - HIRED AUTOS BODILY INJURY (PeraCCidenl) $ - NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per aCCident) GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ ~ESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 0 CLAIMS MADE AGGREGATE $ . ~ DEDUCTIBLE I -- $ -- I $ RETENTION $ $ WORKERS COMPENSATION AND I~R~TC~S I I OTIER EMPLOYERS' LIABILITY At('fPROPRIETOR/PARTNERlEXECUT1VE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUOED? EL DISEASE.EA EMPLOYEE $ Ifye',dncrlbeund" E.L. DISEASE.POLlCY LIMIT $ SPECIAL PROVISIONS btlow OTHER: DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CITY OF ASHLAND IS INCLUDED AS ADDITIONAL INSURED PER CG2010(7/04) CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WLL ENDEAVOR TO MAIL 30 DAYS 90 N MOUNTAIN AVE WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO ASHLAND, OR 97520 DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE MID VALLEY GENERAL AGENCY t-l ZJ~: LLC 4-c ,e. Attention: KARl OLSON Herman R Deiss ACORD 25 (2001/08) Certificate # 43234 @ACORDCORPORATION 1988 POLICY NUMBER: CPS1104202 EINGINEERED MONITORING SOLUTIONS, LLC COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Locationls) Of Covered Operations Or Oraanization(s): CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND, OR 97520 ATTN:KARIOLSON POLICY PERIOD: 12-03-2009 TO 12-03-2010 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. CG 20 10 07 04 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. @ ISO Properties, Inc., 2004 Page 1 of 1 o