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Home My WebLink About561925 SELECTRON TECHNOLOGIES INC - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDNYYY) 01131/2017 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. Astatementon this certificate does notconfer rights to the certificate holder in lieu of such endorsement(s). PRODUCER WB Adams Co. CONTACT WB Adams Co. PHONE 503 644-9945 Fax 503 644-9997 EMAIL . info@wbadams.com General Insurance INSURERS AFFORDING COVERAGE NAIC# 14737 SW Millikan Way INS RERA: Sentinal Insurance Company Beaverton OR 97003 INSURED INSURERS: Hartford Casual Insurance Co. INSURER C : Selectron Technologies, Inc. INSURER D : 12323 SW 66th Ave. INSURERE: Portland, OR 97223 INSURER F : TE NUMBER REVISION NUMBER: COVERAGES %,L- ICA 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 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. ILSR TR A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0 OCCUR ADDLSUBR POLICY NUMBER 52SBAR09216 POLICY EFF MM! 01/3112017 POLICY EXP MMIDD 01/31/2018 LIMITS EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $1,000,000 MED EXP (Any oneperson) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 17 PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000'000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 52UECPT5600 01/31/2017 01131/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ $ A X UMBRELLA LIAB X EXCESS LIAB OCCUR CLAIMS -MADE 52SBAR09216 01/31/2017 01131/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 X WC STAI'UTq_- OTH- $ DED RETENTION WORKERS COMPENSATION E.L. EACH ACCIDENT _, $1,000,000 B AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR(PARTNERIEXECU I IV6— OFFICER/MEMBEREXCLUDED? tMandatory In NH) If yes, describe under DES RIPTION F OPERATIONS below.. NIA 52WBCGI3039 �011,131,12111, 01/31/2018 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L.DISEASE POLICY LIMIT $1,000 000 A Data Breach/Cyber Liability Retroactive Date 01/3112014 52SBAR09216 01131/2017 01/31/2018 Limit $2,000,000 Ded. $5,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is named as additional insured in respects to the General liability when required by written contract. GEK I It-II;A I t n 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. AUTHORIZED REPRESENTATIVE �,noo -�nen Amen rnapnRATION_ All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD