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Home My WebLink AboutNORTHWEST SIGNAL SUPPLY INC - INSURANCE CERTIFICATE (4)/-1 ® A�oRo CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYI'YY) 09106I2013 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. N 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 endomement(s). PRODUCER AOn Risk Insurance Services West, Inc. Portland Oregon Office CONTACT NAME: (NC NNo.Eat): (503) 224-9700 aC. No.: (503) 295-0923 851 SW 6th Avenue EAIAL Suite 385 ADDRESS: Portland OR 97204-1309 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: SAIF Corporation 36196 Northwest Si Dnal SUDDIV. Inc. INSURER B: 12965 SW Herman Rd - INSURER O: Tualatin OR 97062 USA INSURER D: INSURE0. E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570051203280 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 am as requested LTR TYPE OF INSURANCE INSR VIVO POLICY NUMBER MkVDD LILLY E., "IMIDDIYYYYI LIMITS GENERAL LUMBILRY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑OCCUR EACH OCCURRENCE PREMISES Es occurrence NED EXP(Any one person) PERSONAL S ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES POLICY PRO- PER: LOC PRODUCTS - CONPIOP AGG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS NON-0WNED AUTOS COMBINED SINGLE LIMIT BODILY INJURY ( Per person) BODILY INJURY(Perepcidan) PROPERTY DAMAGE Par arrident UMBRELLA DAB EXCESS LMB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED RETENTION A WORKERS EMPLOYERS' UMILRY ION AND YIN ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If da-nhe ander DESCRIPTION OF OPERATIONS GeIdw NIA 370560 10/01/2013 10/01/2014 X TORY LIMITS FIR EL. EACH ACCIDENT S500,000 E.LDISEASE-EAEMPLOYEE $500,000 E.L. DISEASE -POLICY LIMIT $500,000. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101, Additional Remarks Schedule, It more space Is required) Named Insured includes NWS Traffic Engineering. CERTIFICATE HOLDER CANCELLATION 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 Fort Collins AUTHORIZED REPRESENTATIVE Purchasing Division - p N Mason St. F1 For 805 Fort Collins CO 80524 USA 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD