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HomeMy WebLinkAbout513344 ATHENA ADVANCED NETWORKS INC - INSURANCE CERTIFICATE (3)ACOR" CERTIFICATE OF LIABILITY INSURANCE `i DATE(MMIDD/Y18 02/27/20 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 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 endorsement(s). PRODUCER Hart Insurance Agency PO Box 1240 CONTACT NAME: Kristin Wick PHONE FAX I N Ex : (541) 779-4232 A/C No: (541) 772-3963 E-MAIL ADDRESS: Grants Pass OR 97528 INSURE S AFFORDING COVERAGE NAIC # INSURER A: Sentinel Insurance Company LTD 11000 INSURED (541) 899-9596 Athena Advanced Networks Inc INSURER B: Hartford Fire Insurance Com an INSURER C INSURERD: 4497 Brownridge Terrace Ste 107 INSURERE: Medford OR 97504 INSURER F : COVERAGES CERTIFICATE NUMRER- Cart ID 6576 RFVISION 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 LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DD/YYYY LIMITS A X'. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 � OCCUR Y 52SBAPW5507 04/13/2018 04/13/2019 AMAGE TOCLAIMS-MADE PREMSES EaoccurRETEance $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL BADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY PRO- JECT LOC R PRODUCTS - COMP/OP AGG $ 4,000,000 Tech E&O Liability $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ * ANY AUTO 52SBAPW5507 04/13/2018 04/13/2019 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ R HIRED NON -OWNED AUTOS ONLY Ix AUTOS ONLY PROPER'; DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ B AND EMPLOYERS' LIABILITY AND EMPSYERS'LSAILIT YIN 52WECDQ2113 02/28/2018 02/28/2019 X STATUTE PER ERH ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A - E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 11000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) certificate holder is listed as additional insured per attached form SS0008 CERTIFICATE HOLDER CANCELLATION The City of Fort Collins, CO 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. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1