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HomeMy WebLinkAboutONSITE ELECTRONICS RECYCLING DBA IT REFRESH - INSURANCE CERTIFICATE (2)ONSIT-1 CERTIFICATE OF LIABILITY INSURANCE OP ID: CBM DATE (MMIDDIYYYY) 03/2d/2020 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 polI,cy(ias) must have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER 925-513-9080 OLS Insurance Services PO Box 505 Knightsen, CA 94548 Diane Stockman N M ! CT Diane Stockman PHONE 925.513-9080 FAX 925-281-5742 (A/C, No, Eat): (A/C, No): -M I iane@dlsins.com INSURER(SI AFFORDING COVERAGE NAIC 0 INSURER A: Arch Insurance Co. 11150 uINSURERe:PinnacolAssurance s T D rycs RecyclingA: T e rest 1 �Y1agn9,ja Unt D,Box 141 rt OIIIO3s, GcL� 605 i 41190 wsuliERc:Admiial Insurance Company 24856 INSURER D INSURER E: INSURER F: Cr1VFRAGFR r:FRTIFIftATF Ml lRiRFR• RFVIR1r1N NIIMRFR• 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 TYPE OF INSURANCE DDL SUER POLICY NUMBER POLICY EFF POLICY EXPIML OMITS C X COMMERCIAL GENERAL UABIUTY CLAIMS -MADE [X] OCCUR Professional X FEI-EIL-21762-04 FEI-EIL-21762-04 07/01/2019 07/01/2019 07/01/2020 07/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea ggwallnce)C $ 50,000 X MED EXP (Any one pemon) $ 6,000 PERSONAL A ADV INJURY $ 1,000,000 GEN'L X AGGREGATELIMIT APPLIES PER: POLICY D jre7 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOPAGG .$ 2,000,600 A AUTOMOBILE LIABILITY OWNED SCHEDULED IxANY AUTO AIUITEEO��S ONLY !� AUTOS AUR70S ONLY X IN 05 ONLY X FBCAT0461000 09/21/2019 07/01/2620 GLELIMIT COMBINED (Ea $ - - 1,000,000 BODILY INJURY Perperson) $ BODILYBOODILY INJURY Per accident $ PPeOr accdent AMAGE $ C UMBRELLA LIAB EXCESSUAB X OCCUR CLAIMS -MADE FEI-EXS-21763-04 07/01/2011 07/0112020 .EACH OCCURRENCE $ 4'000'000 X AGGREGATE $ 4,000,006 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS'UABIUTY YIN ANY PROPREIIETggOEERIPARTNERIEXECUTIVE ❑ (mranAaroryln NHj EXCLUDED? - If yes, descnbe under DESCRIPTION OF OPERATIONS below NIA 216109 04/01/2020 04/01/2021 X PERSTAT T OTH. E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT __ 1,000,000 C C Env Impairment Pollution FEI-EIL-21762-04 FEI-EIL-21762-04 07/01/2019 07/01/2019 07/01/2020 07/01/2020 Env Imp Pollution 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, my be attached H. more space Is required) Re: E-Waste Recycling Services City of Fort Collins named as additional insured with respecty to General Liability and Automobile Liability City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUUTH/OORRIIIZZ�/ED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved,. The ACORD name and logo are registered marks of ACORD NOTEPAD Onsite Electronics Recycling ONSIT-1 PAGE 2 INSURED'S NAME OP ID: CBM Date 03/24/2020 19-20 Term Cyber Liability -Philadelphia Insurance Company, Policy#PHSD1460817 Claims Made form Retroactive Date 7-20-2011 applies to: Network Security and Privacy Liability Coverage, Employeee Privacy Liability and Electronic Media Liability Coverage Coverage limits- Cyber Extortion Threat $1,000,000 Network Security and Privacy Lilability Coverage $1,000,000 Employee Privacy Liability Coverage $1,000,000 Electronic Media Liability Coverage $1,000,000 Cyber Terrorism Coverage $1,000,000 Deductibles $10,000 Each Loss 09/21/2019 TO 07./l/2020 Auto form FAIC=SKLBUS-AUE (06/01) Additional Insured Auto Waiver of subrogation form CA 04 44 10 13 Non Owned Hired Physical Damage Auto must be scheduled for coverage to apply. 19-20 Term Environmental Impairment Liability Limit-SIR/Deductible $5,000 Per Claim $1,000,000 per Pollution Condition/$2,000,000 Aggregate Pollution Condition Limit Contractors Pollution Liability Limits'SIR/Deductible $5,000 Per Pollution Condition $1,000,000 each claim/$2,000,000 Aggregate Professional Liability Limits (E&O)-Deductible $5,000 per Wrongful Act $1,000,000 Damage Limit each Occurrence/$2,000,000 Aggregate Claims Made Retro Date 12-28-2004 GL Additional Insured Does not apply to Professional Liability form ECC-319-0712 GL Waiver of Subrogation Does not apply to Professional Liability formECC-320-0712 GL Primary non contributory ECC-548-0317 All apply when required by written contract