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HomeMy WebLinkAboutInsurance Certificate: Polaris Land Surveying A��°® CERTIFICATE OF LIABILITY INSURANCE 8 13/2011 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 NpMTACT S. Sorensen Assurance Risk Managers, Inc. PHONE (303)954-9562 1 FA% Nal' 2851 S. Parker Road E-MAIL .ssorensen @arm-i.com pit Suite 760 INSURERS AFFORDING COVERAGE NAIC0 Aurora CO 80014 INSURERABeazley Insurance b7540 INSURED INSURER B: Polaris Land Surveying, LLC INSURER C: 151 Clear Creek Dr. INSURER : D Spite 101 INSURER E: Ashland OR 97520 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1181312011 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 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 TYPE OF INSURANCE ADDL POLICY NUMBER MWOCY EFF R M yLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea WE mencel S CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ PERSONAL B ADV INJURY S GENERAL AGGREGATE S GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S POLICY 7 PRO- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Peraccldent 8 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI I I RETENTIONS S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT 8 OFFICER/MEMBER EXCLUDED' ❑ NIA (Mandatory In NH) - E.L.DISEASE-EA EMPLOYE $ If yes,deacnoi,antler DESCRIPTION OF OPERATIONS Iulow E.L.DISEASE-POLICY LIMIT E A Professional Liability VISU9A100401 /28/2011 /28/2012 Each Claim 500,000 Claims Made Policy Aggregate 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is remen i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, Oregon and It's ACCORDANCE WITH THE POLICY PROVISIONS. Elected Officials, Officers S Employees 20 E. Main St. AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Lisa Isom/SRS '-r- - ---- —> ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn26nninns m Th.A1-nPn name and lnnn am roni.harerl mark.of A(R1Rn