HomeMy WebLinkAbout561925 SELECTRON TECHNOLOGIES INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDIONYYY)
[BELOW,
IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
02/16/2016
RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the terms and conditions of the policy, jrtain politcies may require an he endorsement. A statement on this certificate does not confer rights a the
c
p o(ic y(!es) must be endorsed. If SUBROGATION IS WAIVED, subject to
certificate holder in lieu of such endorsernent(s).
PRODUCER
coNTAcr W 13Adams Co.
W.B. Adams Co.
PHONE 503 644-9945 Fax
General Insurance 503 644-9997
E-MAIL info wbadams.com
14737 SW Millikan Way
Beaverton OR 97003 INSURRRIc, Ao n,.,
INSURED
Selectron Technologies, Inc.
12323 SW 66th Ave.
Portland, OR 97223
Com
Co.
COVERAGES CERTIFICATE NUMBER: INSURER F
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAREVIMED A$OSION VEBFOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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.
TR I TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY
GENERAL LIABILITY POLICY NUMBER M /DDlYYYYI rMUL1,C n EXP P,
A X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Xl OCCUR 711013743-0001 01/31/2016 01/31/2017
X Ded:$0
GEN'L AGGRErG�TE LIMIT APPLIES PER:
AUTOMOBILE LIABILITY
X ' ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS TTF71I013743-00()l 01/31/2016 01/31/2017
HIRED AUTOS ANONO.OSWNED
J( UMBRELLA LIAB 2(
OCCUR
EXCESS LIAB CLAIMS -MADE 711013743-0001
01/31/2016 01/31/2017
DED RETE ION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICE�MEMBERL-XCWDED7ECUTIVQ �ry N/A
(Mandatory in NH) u 52WBCG1s039 01/31/2016 101/31/2017
If yes, describe under
CsCURRE.NCE
�PERACMOCCURRENCE
$1,,000 00(
TO RENTED a
1,000,OOC
MED EXP An one person
$10,000
PERSONAL & ADV INJURY
$1,000,000
GDDAMAGE
GENERAATE
$2000,000
PRODUCTS -MP/OP AGG
$ 2,000,000
$2,000,000LE
LIMIT1,000,000
(Per person)
2412Liabili
$
(Per accident) $AGE
$
Technology Services E & O ELI. -POLICY
Retroactive Date 01/31/2002 711013743-0001
r0113112016 01/31/2017 Limit: $2,000,000
SCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required} ty Of Fort Collins is named as additional insured in respects to the General liability when required by written contract.
Tc unr nrr.
1
Ded: $25,000
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE . DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522
AUTHORIZED REPRFRFu7ea'1tr .e;" y ,
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