HomeMy WebLinkAboutSELECTRON TECHNOLOGIES, INC. - INSURANCE CERTIFICATEA� � �ATE (MM�DDlYYW�
CERTIFICATE OF LIABILlTY INSURANCE o„Z9,Zoz4
THiS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOM 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
REPRESENTATfVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: 1f the certificate holder is an ADDITIONAL IN5URED, the policy(fes� must have ADDITIONAL INSURED provisions or be endorsed.
ff SUBROGATEON IS WAIVED, subject to the terms and conditions of the policy, certaln policies may require an endorsement A statement on
this certlficate does not confer rlghts to the certificate holder in lieu of such endorsement(s).
PRODUCER NTA T Gillian Baker
NAME:
M&G Insurance PHONE FAx
A!C No E�R : AIC No :
412 Jefferson Parkwa Ste 203 E-MAIL �rts@mymqteam.com
Y nnneFss
INSURER(S)AFFORDING COVERAGE NAIC R
Lake Oswego OR 97035 iNSUReRn: Sentinel insurance Company, Ltd 17000
INSUREO iNSUReR s: Harttord Accident and Indemnity Company 22357
Seleciron Technologies, Inc. iNsuReR c: The Hartford Financial Services Group, Inc 00914
Sel@CirOn EnterptiSe ServiC2S LLC iNSUrtER n:
12323 SW 66th Ave INSURER E:
Portland �FZ 97223 INSURER F:
COVERAGES CERTIFICATE NUMBER: 24I25 GL BA CYB XS WC REVi510N NUMBER:
THIS IS TO CERTIFY THAT THE POLIClES OF IIVSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOft THE POLICY PERIOD
INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTftACT OR OTHER DOCUMEfJT WlTli RESPECT TO WHICH Tt-IIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS A1JD CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEM REDUCED 8Y PAID CLAIMS.
IMSR P LI Y EFF P LI Y EXP
�7R TYPE OF INSURANCE IM50 NND POLICY NUMBER MMlDDIYYYY MMlDD1YYYY LIMITS
x COMMERCIAL GEIJERAL LIABILITY EACH OCCURRENCE S 7,000,000
Cv+IM^,rMA�E � OCCUR pREMISES Ea ocwrtence S 1,000,000
MEO F�CP An one rson) S 10,000
A Y 52SBAFt09216 01/3112024 01l3112025 pERS6NnL8ADVINJURY S 1,000,000
GEN'I.AGGREGATELIMITAPPLIESPER: GENERALAGGREGATE S 2,000,000
POLICY � jEa � LOC PROOUCTS-COMPlOPAGG S 2•000,000
OTHER' §
AUTOMOBILE LIABILITY COMBIIJE� SIMGLE LIMIT § �,000,000
Ea accidenl
X ANYAUTO BOOI�Y INJURY (Per person) 5
g OWNEO SCHEDVIED 52UECPT5600 01/3112024 01131/2025 BOOI�Y INJURY (Per accident) S
AUTOS ONLY AUTOS
HIREO NON•OWNED PROPERTY DAMAGE s
AUTOS ONLY AUTOS ONLY Per acadent
Uninsured motorist S 1 000.000
UMBREL�u. LIAB "' "' ""''"' """' S 000.000
X X OCCUR EACH OCCURRFNCF E
A EXCESS UAB CLnIMS�MnDE `�2SBARp9216 01/3112024 01131/2025 qGGREGnTE S 5 000.000
DED X RETENTION S 1D�000 S
WORKERS COMPENSATION /� STATU7E ERH
AND EMPLOYERS' LIABILIN y! N 1 OUO 000
C ANYPROPRIETOR/PAHTNERlEXECUTIVE ❑ N�A 52WBCGI3039 01l3112024 Oli$1/202$ ��L EACHACCIDEN7 S
OFFICERlMEM9ER EXCLUOED9
(Mandatory In NH) G.L DISEASE - F1i EMPLOYEE S � OUO 000
If yes, doscribe undar 1 000 000
OESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIM1T 5 �
Each wrongtul act 2A00 000
Media Liability - claims made
A 52SBAR09216 01I31/2024 01131/2025 Aggregate limit 2,000.000
reiro date 7l14l2014
OESCRIPTION �F OPERAT1pN51 LOCAT10N51 VEHICLES (ACOR� 107, Adtlitional Remarka Schetlule, may 6e attached if more space is requirad�
The City of Fort Collins is named as additional insured provided this is required by prior writlen contract per the attached endorsement
TE HOLDER
City of Fort Collins
PO Box 580
Fort Collins,
ACORD 26 (2016103)
SNOU�D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE�LED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIQNS.
AUTHORIZED REPRESENTATVE
CO 80522 �'""` �`'8'�"�
O 1988-2015 ACORD CORPOf2A710N. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACO �
�../
AGENCY CUSTOMER ID: 00162567
LOC #:
ADDITIONAL REMARKS SCHEDULE
Page of
AGENCY NAMEDINSURE�
M&G Insurance Selectron Technologies, Inc. Seleclron Enterprise
POLICY NUMBER
CARRIER NAIC CODE
EfFECTIVE OATE:
r_i.��r�t.l.r_l�:i�,�,r_���
The ACORD name and logo are registered marks of ACORD
ACORD 101 (2008101� O 2p08 ACORD CORPORATION. All rights reserved.