HomeMy WebLinkAboutInsurance Certificate: Aarons Lawn Service CERTIFICATE OF LIABILITY INSURANCE °ATE 2812 YYYY)
8/28/2012
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).
PRODUCEII THE INSURANCE CENTER CONTACT,
NAME:
PO BOX 6 — PHONE FAX
JACKSONVILLE,OR 97530 4AIC,No.E.0-
EMAIL
PHONE NO. (541)899-9535 N'SURER 5 AFFORDING COVERAGE NAIC k
INSURED AARON NASCIMENTO INSURERA: RED SHIELD INSURANCE COMPANY 41580
DBA:AARON'S LAWN SERVICE INSURER B:
1101 COMET AVE INSURER C:
CENTRAL POINT,OR 97502 E MR D:
NSUTER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER:
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 BEISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECITO ALL THETERMS, EXCLUSIONS
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE 1,000,000
COMMERCLLL GENERAL LIABILITY DAMAGE TO RENTED 100,000 eeI)
A CLAMS-MADE OCCUR CNT 016641 4/20/2012 4/20/2013 MED up(my one perm-) 5,000
PERSONAL&ADV INJURY 1,000,000
GENERAL AGGREGATE 2,000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS:COMP/OPAGG Incl in Gen Agg
J( POLICV PROIECr F_ ] LOC
AUTOMOBILE LIABILITY. COMBINED SINGLE LIMIT
(E4 amtleot
ANY AUTO BODILY WHEN(Per person)
ALL OWNED SCHEDULED BODILY INJURY(Peramidean
AUTOS AUTOS
HIRED AUTOS NON-OWNED PROPERTY DAMAGE(Per
AUTOS accident
UMBRELLA LLAB OCCUR EACH OCCURRENCE
EXCESS LIAR CLAMS-MADE - AGGREGATE
DED RETENTION
WORKERS COMPENSATION WC STATE' OTfl-
AND EMPLOYERS'LIABILITY YAS TORV LIMI E
ANYPROPRIFTORMARTNER/EXECUTIVE ❑ N/A E.L.EkCH ACCIDENT
M E
OFFICERMBER EXCLUDED?
(Mandatory In NH) E.L.DISEASE-EA.EMPLOYEE
If yes,de.eribe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(A W ch ACORD IBI,Additional Remar"Schedule,If more space u required)
ALL OPERATIONS USUAL TO THE NAMED INSURED AS PER POLICY TERMS AND CONDITIONS
LAWN CARE SERVICES
City of Ashland is named Additional Insured,
The Certificate Holder is included as an additional insured pursuant to ISO form CG 3261(10/05)a copy of which is attached
hereto for informational purposes.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS.
20 E MAIN ST AUTHORIZED REPRESENTATIVE
ASHLAND,OR 97520 74
1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: CNT 016641 COMMERCIAL GENERAL LIABILITY
CG 32 6110 05
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OREGON ADDITIONAL INSURED - OWNERS,
LESSEES OR CONTRACTORS - SCHEDULED PERSON
OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
CITY OF ASHLAND
20 E MAIN ST
ASHLAND, OR 97520
Location(s) Of Covered Operations:
All locations where the insured performs ongoing business operations.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to B. With respect to the, insurance afforded to these
include as an additional insured the person(s) or additionai insureds, the following additional
organization(s) shown in the Schedule, but only exclusion applies:
with respect to liability for "bodily injury",
"property damage" or "personal and advertising This insurance does not apply to "bodily injury" or
injury" caused by your ongoing operations for the "property damage" occurring after:
additional insured(s) at the location(s) designated 1. All work, including materials, parts or
above and only to the extent that such "bodily equipment furnished in connection with such
injury", "property damage" or "personal and work, on the project(other than service,
advertising injury" is caused by your negligence or maintenance or repairs)to be performed by or
the negligence of those performing operations on on behalf of the additional insured(s)at the
your behalf. location of the covered operations has been
completed; or
2. That portion of"your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
CG 32 61 10 05 Copyright, ISO Properties, Inc., 2005 Pagel of 1 El