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HomeMy WebLinkAbout561925 SELECTRON TECHNOLOGIES INC - INSURANCE CERTIFICATEACORO CERTIFICATE OF LIABILITY INSURANCE `� DATE(MM/DD/YYYY) 01 /22/2019 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 WB Adams Co. General Insurance 14737 SW Millikan Way Beaverton OR 97003 CONTACT Bri Sandland PHONE 503 644-9945 FAX 503 644-9997 annpF_E-MAIL CommerciaiLZ@wbadams.com INSURERS AFFORDING COVERAGE NAIC # INSURERA: Sentinel Insurance Company 11000 INSURED Selectron Technologies, Inc. 12323 SW 66th Ave. Portland, OR 97223 INSURERB: Hartford Casualty Insurance Co. 29424 INSURERC: INSURERD: INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ! THIS IS TO rERTIPY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED I U 1 HE 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYYI POLICY EXP (MMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 1 000 000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR Y 52SBAR09216 01/31/2019 01/31/2020 MEDEXP (Any oneperson) $10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 Deductible $ 0 X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO BODILY INJURY (Per accident) $ ALL OSCHEDULED AUTOS AUTOS 52UECPT5600 01/31/2019 01/31/2020 PROPERTY DAMAGE $ NON -OWNED HIRED AUTOS AUTOS Comp/Coll DeductiblE $ 500/500 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $5,000,000 A EXCESS LIAB CLAIMS -MADE 52SBAR09216 01/31/2019 01131/2020 DED I I RETENTION $10,000 Deductible $ 0 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? ANY ECUTIV� (Mandatory in NH) N /A 52WBCGI3039 01/31/2019 01/31/2020 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,ODU E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 Data Breach/Cyber Liability 52SBAR09216 01/31/2019 01131/2020 Per Claim: $1,000,000 Agg: $2,000,000 A Professional Liability/E&O 52SBAR09216 01/31/2019 01/31/2020 Each Occ: $2,000,000 Agg: $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins is named Additional Insured as respects to General Liability when required by written contract. L;tK I II-IL:A I t HULUtK GANGtLLA I IUN City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 I AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved.