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HomeMy WebLinkAboutInsurance Certificate: Metal Masters OP ID: KIY CERTIFICATE OF LIABILITY INSURANCE °ATE'MM°°"YYY' 10)01/12 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 CONTACT 541-773-5358 NAME: Kendall Yeaw Protectors Insurance,LLC 541-772-1906 PHONE FAX Pilot Rock Ins Agency LLC(CA) ac No Ext:541-842-2963 AIC No: 541-772-1906 Me Box ,4669 OR ADDRESS: kendally@protectorsins.com Medford,OR 97501 PRODUCER METAL-1 Dennis C.Flenner Cu T MERIDp: INSURERS AFFORDING COVERAGE NAIC 9 INSURED Metal Masters Inc INSURER A:American Fire and Casualty 3825 Crater Lake Hwy INSURER B:Ohio Security Insurance Medford,OR 97504 INSURER C:Ohio Casualty Insurance INSURER D:SAIF Corporation 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 TYPE OF INSURANCE POLICY EFF POLICY EXP TR POLICY NUMBER MNUDD/YYYY 1 IMMIDDNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BKA55281530 10101/12 10101/13 PREMISES Ea oc a al nte $ 1,000,00 CLAIMS-MADE 1K OCCUR MED EXP(Any one person) $ 15,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER - PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO LOC $IPr.T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 B X ANY AUTO BAS55281530 10/01/12 10/01/13 (Ea accident) BODILY INJURY(Per laerson) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS S $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,00 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 2,000,00 C US055281530 10101/12 10/01/13 DEDUCTIBLE $ RETENTION_ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY D ANY PROPRIETORIPARTNERAIXECUTIVE YIN 812266 10/01112 10101/13 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? F-1 MIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 H yes,describe under DE SCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more apace Is required) As additional insured per policy endorsement CG8811(1009): CERTIFICATE HOLDER CANCELLATION D /J SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland D v THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Hall ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 OCT - 5 2012 AUTHOR9ED REPRESENTATIVE Dennis C. Flenner ©1988.2009 ACORD CORPORATION. All rights reserved. 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