HomeMy WebLinkAboutInsurance Certificate: Goseetell Networks Inc
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ACORD" CERTIFICA TE OF LIABILITY INSURANCE I DATEIMM/DDIYYYY)
~ 05-27-2011
THIS CERTIFICATEIS 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 INSURERIS!. AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONALlNSURED, the policyliesl must be endorsed. If SUBROGATIONIS 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 endorsementCs).
PRODUCER NAME~l.1
KPD INSURANCE, INC!PHS PHONE (866)467-8730 l,tfc.Nolo (877) 905-045
700810 P: (866)467-8730 F: (877) 905-0457 fAIC No Ext\:
PO BOX 33015 ~-~D~~SS:
SAN ANTONIO TX 78265 CUSTOMER ID Ii:
INSURER(Sl AFFORDING COVERAGE NAIC#
INSURED INSURER A : Hartford Casua1tv Ins CO
GOSEETELL NETWORKS INC INSURER B :
3108 NW LURAY TER INSURER C : I
PORTLAND OR 97210 INSURER 0 :
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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH nus
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.
INS TYPE OF INSURANCE IMM~DDrvYYvI I IMMI~DfYWY) LIMITS
LTA IINSR WVD POLICY NUMBER
GENERAL LIABILITY EACH OCCURRENCE I, 2,000 000
f- PREMisEs '(Ea"~""c'u~~nce) ,300,000
COMMERCIAL GENERAL LIABILITY
A I CLA!MS.MADE LKJ OCCUR MED EXP (Anyone personl ,10,000
-K General Liab X 52 SBM UR7842 07/15/2011 07/15/20121 PERSONAL & ADV INJURY ,2,000,000
- I GENERAL AGGREGATE ,4,000,000
_@f!fL AGGREGATE LIMIT APPLIES PER; I PRODUCTS- COMP/OPAGG I $ 4,000 ,000
1 POLICY U j~2T lXJ LOC I'
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT '2,000,000
- (E8accident)
- ANY AUTO BODILY INJURY (Per person)
,
- ALL OWNED AUTOS BODILY INJURY (Per accident} $
A - SCHEDULED AUTOS PROPERTY DAMAGE
52 SBM UR7842 07/15/2011 07/15/2012 $
-4 HIRED AUTOS (Per accident)
-K NON-OWNED AUTOS ,
. ,
UMBREllA L1AB U OCCUR I EACH OCCURRENCE ,
- EXCESS UAB I~ I CLAIMS-MADE
AGGREGATE ,
_ DEDUCTIBLE ,
I RETENTION , ,
WORKERS COMPENSATION I T~~{[~~S I IOl~-
AND EMPLOYERS' LIABILITY VIN
ANY PROPRIETORfPARTNER/EXECUTIVEU NIA E.L. EACH ACCIDENT ,
OFFICER/MEMBER EXCLUDED?
(MlII'ldIltory in NH) E.l. DISEASE - EA EMPLOYE ,
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT ,
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additionsl Remsrks Schedule. if more spllce is required)
Those usual to the Insured's Operations. City of Ashland is an Additional
Insured per the Business Liability Coverage Form SSOO08.
CERTIFICATE HOLDER
CANCELLATION
v\\ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
V BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
City of Ashland ~~~ DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
20 E MAIN ST AUTHOR~7:;:'VE 7 ~~~
ASHLAND, OR 97520
ACORD 25 (2009/09)
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