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HomeMy WebLinkAboutTELELANGUAGE INC - INSURANCE CERTIFICATE (2)TELEL-1 OP ID: CD ACORD 702110/2016 (MM/DD)�CERTIFICATE OF LIABILITY INSURANCE (MMIDfYY 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 endorsements). PRODUCER CONTANAME: I Darrin Gross Leonard Adams Insurance, Inc. PHONE FAX 5201 SW Westgate Dr, Suite 300 A/C No Ext :503-296-0077 A/C No): 503-296-0044 Portland, OR 97221 E-MAIL J. Darrin Gross ADDRESS: darring@lacoinsurance.com INSURERS AFFORDING COVERAGE NAIL # INSURER A: Sentinel Insurance Company 11000 INSURED Telelanguage Inc INSURER B : SAIF 514 SW 6th Ave, 4th FI INSURER C : Scottsdale Ins Co 41297 Portland, OR 97204 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 AbaILTR TYPE OF INSURANCE INSD SWVD UB - POLICY NUMBER MM/DD/YYYY MM/ D/YYYY TR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE FxI OCCUR X 52SBAPW5861 03/17/2016 03/17/2017 DAMAGE TO RENTED PREMISES Ea occurrence 1 OOO OO $ r , MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY JERT 7 LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1 000 00 BODILY INJURY (Per person) _ $ A ANY AUTO 52SBAPW5861 03/17/2016 03/17/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ _ PROPERTY DAMAGE Per accident X X NON -OWNED HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 A EXCESS LIAB CLAIMS -MADE 52SBAPW5861 03/17/2016 03/17/2017 DED X RETENTION$ 10,000 _ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE 799269 04/01/2016 04/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYEE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 C Professional Liab EK13152929 03/17/2016 03/17/2017 Per Claim 1,000,00 Ag9 3,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as an additional insured with respect to General Liability. CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE J. Darrin Gross / �zl__I ar_~ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD TELEL-1 OP ID: CD ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) F06/29/2015 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 Leonard Adams Insurance, Inc. 5201 SW Westgate Dr, Suite 300 Portland, OR 97221 CONTACTNAME: J. Darrin Gross PA//CONNo Ell: 503-296-0077 ac No): 503-296-0044 E-MAIL ADDRESS: darring@lacoinsurance.com J. Darrin Gross INSURERS AFFORDING COVERAGE NAIC # INSURER A: Sentinel Insurance Company 11000 INSURED Telelanguage Inc INSURERB:SAIF 514 SW 6th Ave, 4th FI Portland, OR 97204 INSURER C : Scottsdale Ins Co 41297 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDrfYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE X OCCUR 52SBAPW5861 03/17/2016 03/17/2017 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,00( MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY JE � LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) _ $ A ANY AUTO 52SBAPW5861 03/17/2016 03/17/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 A EXCESS LIAB CLAIMS -MADE 52SBAPW5861 03/17/2016 03/17/2017 DIED X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 799269 04/01/2016 04/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,00 C Professional Liab EKI3152929 03/17/2016 03/17/2017 Per Claim 1,000,00 I Agg 3,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 A AZ�— �~ J. Darrin Gross %' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD