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Home My WebLink AboutNORTHWEST SIGNAL SUPPLY INC - INSURANCE CERTIFICATEACORO� �- CERTIFICATE OF LIABILITY INSURANCE DAT tonoti m 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 AGA RI,k I.SU ranCP services West, Inc. Portland Oregon office CONTACT NAME: lac NO.Eag: (503) 724-9700 FAX No: (503) 295-0923 E-MAIL ADDRESS: 951 sW 5th Avenue Suite 385 Portland OR 97204-1309 USA INSURERS) AFFORDING COVERAGE NAICC INSURED INSURER A: SAIF Corporation 36196 Northwest signal Supply, Inc. 12965 SW Herman Rd INSURER B: INSURER C: Tualatin OR 97062 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047829883 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. Limits shown are as requested S LTR TYPE OF INSURANCE INSR S R WVD POLICY NUMBER OIL CY FF MOIL Y POL CY E%P Mh4DOM'VY LIMITS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES Ea ...15 rice CLAIMS -MADE ❑ OCCUR DIED EXP(Any one person) PERSONAL& ACV INJURY GENERAL AGGREGATE ATE GEN'L AGGREGLIMIT APPLIES PER: PRODUCTS - COMPIOP AGG PRO- POLICY LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accidem BODILY INJURY ( Per Person) ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPEftiV DAMAGE Per dcGdenl UMBRELLALIAB OCCUR EACH OCCURRENCE EXCESS LIAR H CLAIMS -MADE AGGREGATE DED RETENTION A WORKERS COMPENSATION AND LIABILITY YIN ANY PROPRIETOR I PARTNER I EXECUTIVE 370560 10/01/2012 10/01/2013 X WOVMORTH- EEMPLOYERS' E.L. EACH ACCIDENT $500,000 OIFICERIMEMBER EXCWOED, F9 NIA E. L. DISEASE EA EMPLOYEE 5500,000 (Mandatory in HER I,Y describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD IDt. Additional Remarks Schedule. II more space is required) Named Insured includes NWS Traffic Engineering. CERTIFICATE HOLDER CANCELLATION SHOULD MY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins AUTHORQED REPRESENTATIVE Purchasing Division 215 IN St. F1 For 805 A N'„ Fort Collins CO 80524 USA n nxuitana ctudz9 Pu @1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD m c 0 a 0 M