HomeMy WebLinkAboutInsurance Certificate: Engineered Monitoring Solutions (6)
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ACORD" CERTIFICA TE OF LIABILITY INSURANCE I DATE (MM/DDfYYYY)
~ 11/30/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMA TIVEL Y OR NEGA TIVEL Y 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 pollcy(ies) must 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 ! ~2=~~CT Dee Tudor .. .,.
.. . _. ..-
, r~NJO.91l' (503)624-0466 , W" .
Slater & Associates Inc. . . lAIC No): (503) 624-0846
PO ..Box 1469 jDMDAJ~ss:dee@ slaterinsurance. com
PRODUCE~ .n,/lJ) 0 0 0 62 41
Tualatin OR 97062-14'69 INSURERfS) AFFORDING COVERAGE NAIC.
INSURED INSURER A :SAIF Corp 6196
INSURER B :
Engineered Monitoring Solutions LLC INSURER C :
617 N Main St INSURER 0 :
Newberg, OR 97132 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. NOmTHSTANDING 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 . L /&OLlCY EFF I /=~~%~
LT" TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
I-- g~~~~J9E~~~~nce\
COMMERCIAL GENERAL LIABILITY $
I CLAIMS-MAD~ D ,OCCUR -
. . . MED EXP (Anyone person) $
, PERSONAL & ADV INJURY $
. GENERAL AGGREGATE $
'n'~ AGG~EnE ILlMIT APnSIPER,: PRODUCTS. COMPtOP AGG $
POLICY ~~R,: LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
I-- (Eaaccidenl)
I-- ANY AUTO BODILY INJURY (Per person) $
I-- ALL OWNED AUTOS BODILY INJURY (Per accident) $
I-- SCHEDULED AUTOS PROPERTY DAMAGE
$
I-- HIRED AUTOS (Per accident)
NON-OWNED AUTOS $
I--
$
UMBRELLA L1AB H OCCUR EACH OCCURRENCE $
I--
EXCESS L1AB CLAIMS-MADE AGGREGATE $
I-- DEDUCTIBLE $
RETENTION $ $
A WORKERS COMPENSATION X I T~gJmI,~~ I IO,)',\"
AND EMPLOYERS' LIABILITY VI"
ANY PROPRIETORfPARTNERIEXECUTIVE D E.L. EACH ACCIDENT $ 1 000 000
OFFICERIMEMBER EXCLUDED? "" 12/1/2010 12/1/2011
(Mandatory In NH) 958900 E.L. DISEASE. EA EMPLOYE $ 1 000 000
If yes, describe under $ 1 000 000
DESCRIPTION OF OPERATIONS below E.L. OISEASE . POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
CERTIFICATE HOLDER
CANCELLATION
(541)488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREDF, NOTICE WILL BE DELIVERED IN
CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS.
90 N Mountain Ave
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
Dee Tudor/D"MI! A. ])-'Zo ,-Y-udOY
ACORD 25 (2009/09)
INS025 (200909)
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