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Home My WebLink AboutInsurance Certificate: Engineered Monitoring Solutions (3) ,.~ ACORD" CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlODfYYYY) ~ 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 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 DR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(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 Slater & Associates Inc. r~~~. o~" (503)624-0466 I r~ No': (503)624-0846 PO Box 1469 ~D~~ss: dee@slaterinsurance.com PRODUCER .00006241 Tualatin OR 97062-1469 INSURERfS) AFFORDING COVERAGE NAle# INSURED INSURER A :SAIF Core B6196 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 POLlC[ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER[OD INDICATED. N011N1THSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W1TH RESPECT TO WH[CH THIS CERTIF[CATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HI\REIN [S SUBJECT TO ALL THE TERMS, EXCLUS[ONS AND CONDITIONS OF SUCH POLICIES. L1M[TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA[MS. INSR. * POLICY EFF POUCY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDNYYY IMM/DD/VYVY LIMITS GENERAL LIABILITY EACH OCCURRENCE . - I P~~~ISES YE~~~E~nce\ COMMERCIAL GENERAL LIABILITY . I CLAIMS-MADE D OCCUR MED EXP (Anv one oerson\ . PERSONAL & ADV INJURY . GENERAL AGGREGATE . ~'~ AGG~EnE~L1MlT APnSIPER: PRODUCTS - COMP/OP AGG . POLICY ~[}R.;. LOC . AUTOMOBILE LIABILITY COMBlNED SINGLE LIMIT . - (Eaaccldent) - ANY AUTO BOOIL Y INJURY (Per person) . - ALL OWNED AUTOS BOOIL Y INJURY (Per accident) . - SCHEDULED AUTOS PROPERTY DAMAGE . - HIREO AUTOS (Peraccldent) NON-OWNED AUTOS . - . UMBRELLA LIAS H OCCUR EACH OCCURRENCE . f- EXCESS lIAB CLAIMS-MADE AGGREGATE . f- DEDUCTIBLE . RETENTION . . A WORKERS COMPENSATION X I we STATU., I IOJ~' AND EMPLOYERS' LIABiliTY VIN ANY PROPRIETORlPARTNERlEXECUTJVE 0 E.L. EACH ACCIDENT . 1 000 000 OFFICERlMEMBER EXCLUDED? NIA 12/1/2010 12/1/2011 (MandatolY In NH) 958900 EL. DISEASE - EA EMPLOYE . 1 000 000 Jfyes, describe under E.L. DISEASE - POLICY LIMIT . 1 000 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Ad~ltlonal Remal1l.s Schedule, If more space Is requIred) CITY RECORDER CERTIFICATE HOLDER CANCELLATION (541)488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF ASHLAND 90 N Mountain Ave Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Dee Tudor/Om A, ~ -r-t...-c.do-r ACORD 25 (2009/09) INS025 (200909) @1988-2009ACORDCORPORATlON, All rights reserved, The ACORD name and logo are registered marks of ACORD ~ ~ A,eO_RD' CERTIFICATE OF LIABILITY INSURANCE I DATE {MMlDDlYYYY) 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 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: If the certificate holder is an ADDITIONAL INSURED, the policy(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 Phone: 503-365-7001 Fax: 503-365-7354 CONTACT SLATER & ASSOCIATES INSURANCE NAME: MID VALLEY GENERAL AGENCY LLC '1:gN~o Exl: 1503-624-0466 If~NO': 1503-624-0846 4305 RIVER ROAD N E-MAIL (first name) @slaterinsurance.com KEIZER OR 97303 ADDRESS: ~~~~~~~~ID: 19476 INSURER{S} AFFORDING COVERAGE NAIC# INSURED INSURER A , SCOTTSDALE INSURANCE COMPANY 41297 ENGINEERED MONITORING SOLUTIONS LLC 617 N MAIN ST INSURERS: NEWBERG OR 97132 INSURERC : INSURER 0: INSURERE; INSURERF; COVERAGES CERTIFICATE NUMBER' 47201 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 ~.E~:IFICATE MAY BE ISSUE~ ...O..R...,~:-,~ PERTAIN, ~~~!NSURANCE AF,~?,~~ED BY THE POLICIES DE,S^~~~ED HEREIN IS SUBJECT TO ALL THE TERMS, INSR TYPE OF INSURANCE ADD'L SUBR POLICY NUMBER ~~~~'!!!!.. ,~~~~ L.IMITS "" INSR '"" A GENERAL LIABILITY CPS1104202 12/03/10 12/03/11 EACH OCCURRENCE I 1,0,00,,000 - ~ D~ERCIAL GENERAL LIABILITY g~~~~JOE~~N~~nca\ $ 1,00,,000 - CLAIMS-MADE I~ OCCUR MED. EXP (Anyone person) $ 5,,000 - PERSONAL & ADV INJURY $ 1,0,00,,000 - GENERAL AGGREGATE $ 2,0,00,,000 ~'L AGG:i9AlE ~~~ APPl: PER: PRODUCTS - COMP/OP AGG $ 2,0,00,,000 POLICY I ~:..~ LaC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - (Ea accident) - ANY AUTO BODILY INJURY (Per person) $ - ALL OWNED AUTOS BODILY INJURY (Per accident) $ - SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Peraccident\ $ - - NON-OWNED AUTOS $ $ - UMBRELLA LlAB H OCCUR EACH OCCURRENCE I. EXCESS LIAS CLAIMS-MADE AGGREGATE I. i-- DEDUCTIBLE I. RETENTION $ I WORKERS COMPENSATION I fgR~T~~YTS I 10TH I AND EMPLOYERS' LIABILITY v," I. ANY PROPR1ETORlPARTNERlEXECUTlVE 0 E.L. EACH ACCIDENT OFFICERlMEMBER EXCLUDED? N1A I. (MandaloryfnNH) E.L DISEASE-EA EMPLOYEE IfyeB,deBcribeunder E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATlONS below $ DESCRIPTION OF OPERATIONS f L.OCATlONS I VEHICL.ES (Attach ACORD 101, AddiUonal Remarke Schedule, If more space Is required) 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 90 N MOUNTAIN AVE THE EXPIRATION DATE THEREOF, NOTICE WilL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE Attention: KARl OLSON MID VALLEY GENERAL AGENCY LLC \-l ,e :<J_' - Herman R Deiss ACORD 25 2009/09 @1988-2009ACORDCORPORATION. All ri his reserved, The ACORD name and logo are registered marks of ACORD 9 . ' " 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 endorsem~nt modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additionallnsu~~~person(s) Location/sl Of Covered ODerations Or Ornanization s : CITY OF ASHLAND 90 N MOUNTAIN AVE ASHLAND, OR 97520 <"' ATTN:KARIOLSON POLICY PERIOD: 12-03-2010 TO 12-03-2011 Information reouired to comolete 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 o Page 1 of 1