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HomeMy WebLinkAboutInsurance Certificate: Star Collision Centers �-� acORO' CERTIFICATE OF LIABILITY INSURANCE DA 05/04/2012 THIS CERTIFICATE te5 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICAT.0 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 CERTICATE 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 certifrcate�does not confer-rights to-the. .certificate holder in lieu'of such endiirsemen s. PRODUCER CONTACT Zurich N.A.-Account Service Center Zurich;Account Service Center I .. NAME: - - -- " 7045 College Blvd. - PHONE.Exr: ' ..877-225-5276 ==-- FAX No:- 888-734-6776 . Overland Park, KS 66211_ EMAIL ss: service.center @zunchna.com Fax: 888-734-6776 Ph: 877-225-5276 Opt. 1 INSURERS AFFORDING COVERAGE NAIC# INSURED 012551400 INSURER A: Universal Underwriters Insurance Company 41161 STAR COLLISION CENTERS, INC. DBA,STAR BODY WORKS DBA, INSURER B: Universal Underwriters of Texas Ins. Co. 40843 STAR 24HOUR TOWING OBA,STAR COLLISION CENTER OF INSURER C: ASHLAND, INC. DBA STAR COLLISION CENTERS,INC. DBA STAR INSURER D: COLLISION CENTER STAR COLLISION CENTER OF ROGUE RIVER, INC. 1024 SUMMIT AVENUE - INSURER E: MEDFORD,OR 97501 I 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 TYPE OF INSURANCE DD'L UB POLICY NUMBER POLICY EFF POLICY UP LIMITS LTR MM/DD/YYYY MMIDD/YVYY GENERAL LIABILITY ❑ ❑ EACH OCCURENCE s300,000 A ® COMMERICAL GENERAL LIABILITY DAMAGE TO RENTED $ . PREMISES Ea occurrence ❑❑ CLAIMS MADE ® OCCUR - - MED UP(Any one person) - $ 05-01-2012 05-01-2013 - ❑ q - 276516 ._.::- ._—._—... ._ -_. PERSONAL&ADV INJURY_-__ :_$._ ❑— Y.0 _. -•"<' 1' GENERAL AGGREGATE " GENE AGGREGATE LIMIT APPLIES PER: L "5 - PRODUCTS-COMPIOP AGO $ ❑ POLICY❑ PROJECT❑ LOC T 1... -' I t A AUTOMOBILE LIABILITY O '❑ COMBINED SINGLE LIMIT $300,000 (Ea Accident) F1 ANY AUTO BODILY INJURY(Per person) $ ❑ALL OWNED AUTOS ® SCHEDULED AUTOS 276516 05-01-2012 05-01-2013 BODILY INJURY(Per accident) $ PROPERTY DAMAGE $ ® HIRED AUTOS Per ec.idenl ® NON-OWNED AUTOS $ 1-1 h�I EACH OCCURRENCE $5,000,000 A . I��JJ.I!I UMBRELLA 1.lAR I!:! Of.CUR (, .❑ MUCESS LIAB ❑ CLAIMSMADE y AGGREGATE $ DEDUCTIBLE 276516 06-01-2012 05-01-2013 PRODUCTS-COMPIOP AGG s 15,000,000 ❑ ® RETENTION $0 $ WORKERS COMPENSATION AND VCSFATIT OTH- EMPLOYERS'LIABILITY ❑TORY LIMITS ❑ ER ANY PROPRIETORPARTNER/ ECUTIVE VIN OFFICEPIMEMBER E%CLUOEDP ❑ f.J/q ❑ E L EACH ACCIDENT $ ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,desrnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A GARAGE LIABILITY ❑ ❑ 278516 05-01-2012 05-01-2013 OTHER THAN AUTO ONLY $300,000•ANY AUTO EACH ACC: CUSTOMER AUTO-DIRECT PRI MARY 278516 06-01-2012 05-01-2013 $1,200,000 Limit A Includes On-Hook Coverage ❑ ❑ _____ ____ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If moro space is ruyuired){� � Reason for Certificate: State Requirement CITY R. CA)RDLER 30 day notice of cancellation applies, except for cancellation due to non-payment of premium. 2 �0 CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND 90 NORTH MOUNTAIN AVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ASHLAND, OR 97520 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1968-2010 ACORD CORPORATION,All rights reserved ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:012551400 LOC#: ACOROI' ADDITIONAL REMARKS SCHEDULE Page-3—of-3— AGENCY NAMED INSURED Zurich,Account Service Center STAR COLLISION CENTERS, INC. DBA,STAR BODY WORKS DBA,STAR 24HOUR TOWING DBA,STAR COLLISION CENTER POLICY NUMBER OF ASHLAND,INC. DBA STAR COLLISION CENTERS, INC. DBA 278516 STAR COLLISION CENTER STAR COLLISION CENTER OF ROGUE RIVER, INC. CARRIER NAIC CODE 1024 SUMMIT AVENUE Universal Underwriters Insurance Company 41181 MEDFORD,OR 97501 EFFECTIVE DATE: 05-01-2012 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liabili Insurance 'Products—Completed Operations Aggregate of$900,000 applies to the Garage Liability. Uicover Policy carries liability limits of $300,000 underlying along with a$5,000,000 Commercial Umbrella for a total liability limit of$5,300,000 per occurrence.Auto Liability coverage includes Broadened Coverage Other Property(Cargo in Customers Autos and Traiiers)" ACORD 101 (2008101) ©2008 ACORD CORPORATION,All rights reserved. The ACORD name and logo are registered marks of ACORD