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Home My WebLink About330448 JACO ENVIRONMENTAL - INSURANCE CERTIFICATE (13)A� �® CERTIFICATE OF LIABILITY INSURANCE F09/1 Page 1 of 2 /220 4 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 CONTACT Willie Of Seattle, Inc. c/o 26 Century Blvd. NAM PHONE FAX AI N 877-945-7378 ac N 888-467-2378 AEBMAELss Certificates@willis.COm P. O. Box 305191 Nashville, IN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Aspen Specialty Insurance Company 10717-001 INSURED JACO Environmental, Inc. INSURER B: St. Paul Surplus Lines Insurance Co. 30481-000 INSURERC: California Insurance Company 38865-001 PO Box 14307 Mill Creek, WA 98082 INSURER D: continental Indemnity Company 28258-001 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 22072349 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 TYPEOFINSURANCE DD' SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY ERAAK1414 9/15/2014 9/15/2015 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR DAMAGETORENTED PREMISES Eexcurenoe $ 11000,000 MED EXP(Any one person) $ 5 000 PERSONAL& ADV INJURY $ 2,000,000 X WA Stop Gap Included X $10.000 Deductible GENERAL AGGREGATE $ 2,000.000 GENT AGGREGATE LI MIT APPLIES PE R: PRODUCTS-COMP/OPAGG $ 2,000.000 POLICY X JFCTPRO17 LOC AUTOMOBILE LIABILITY COMBINED SINULL LIMIT (Ea axident $ BODILY INJURY(Per person) $ ANYAUTO HE AUTOS ALLOWNED AUTOSULED BODILY I NJU RY(Per aoddem) $ HIS AUTO$ NON -OWNED AUTOS PROPERTYDAMAGE Per axidern $ $ B X UMBRELLA LIAB X OCCUR ZUP14S7979814F 9/15/2014 9/15/2015 EACH OCCURRENCE $ 5,000 000 AGGREGATE $ 51000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 10,000 Is C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ R/ OFFICEMEMBER EXCLUDED? fMantlM In NH) f Yes , tlescriee under N/A 738773170102 738773170104 9/15/2014 9/15/2014 9/15/2015 9/15/2015 X ELEACHACCIDENT $ 1, 000, 000 E.L. DISEASE -EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS Deb. A ERAAK1414 9/15/2014 9/15/2015 Pollution Legal Liability $2,000,000 Per Incident including BI/PD & Cleanup $2,000,000 Aggregate Policy # ERAAK1413 1 1$ 25,000 Deductible Each Incident DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach Acord 101, Additional Remerka Schadu e. H more apses is inquired) Workers Compensation Policy #73-877317-01-04: Covers the following states: Covers: AZ, CA, GA, NV, OR, TX, UT. Workers Compensation Policy #73-877317-01-02: Covers the following states: IL, IN, MD, MI, MN, NC, NJ, NM, PA. The Umbrella policy also extends over the primary auto liability policy which has a $2,000,000 limit. Cit Alin Purchaein Divi a: ristiae Pattereoa-Jarvis 700 Wood Street Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Coll: AL.VHU zO(zUTWU7I :1862744 Cert:22072349 01988-2010 ACORD 1 ne ACUHO name and logo are registered marks of ACORD reserved AGENCY CUSTOMER ID: LOC#: A ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Willis of Seattle, Inc. POLICY NUMBER See First Page CARRIER NAIC CODE See First Page AUUI I IUINAL RtMARK, NAMED INSURED JACO Environmental, Inc. PO Box 14307 Mill Creek, WA 98082 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Excess Pollution Legal Liability Policy # EXAD93M14 Effective Date: 09/15/2014 Expiration Date: 09/15/2015 Insurance Carrier: Aspen Specialty Insurance Company Limits: $3,000,000 ACORD 101(2008/01) C011:4517918 Tpl:1862744 Cert:22072349 02008ACORD CORPORATION. All rights reserved I he ACORD name and logo are registered marks of ACORD