HomeMy WebLinkAboutInsurance Certificate: TC Chevrolet
ACORD n CERTIFtCNATE OF LIABILITY INS'u Doiisii3Y1
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
FEDERATED MUTUAL INSURANCE COMPANY HOLDER. THIS CERTIFICATE DOES ' NOT AMEND, EXTEND OR
Home Office: P.O. Box 328 ALTER THE COVERAGE AFFORDED BY-THE POLICIES -BELOW.
-i . Owatonna, MN 55060 I COMPANIESIAFFORDING COVERAGE
Ph6n6:1-888-333-4949
COMPANY FEDERATED MUTUAL- INSURANCE COMPANY- OR----------
' A FEDERATED SERVICE INSURANCE COMPANY
INSURED'.. - 276-176-5 COMPANY
I TIC CHEVROLET INC a
PO BOX 249
ASHLAND OR---97520--_.----.--__.-__..._ ---COMPANY
C
COMPANY
D
COV{AGS .
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MMIDDffY) DATE (MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE 5 1,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS- COMP/OP AGG $
A CLAIMS MADE FX70CCUR 9918174 03/01/13 03/01/14 PERSONAL & ADV INJURY $ 500,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE 11 500,000
FIRE DAMAGE (Any one tire) $ 100,000
MED EXP (Any one person) $ 5.000
AUTOMOBILE LIABILITY.:
V'AUTO !~°a :'.t i~If ! COMBINED SINGLE LIMIT
AN $
--ALL'OWNED AUTOS--_.. BODILYJNJURV-_--_..--._-.
SCHEDULED AUTOS (Per person) .5
HIRED AUTOS, BODILYINJURY C.G,...
NON-OWNED "AUTOS (P.r.icad.nt)_.
PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ 500,000
A
X ANY AUTO 9918174 03/01/13 03/01/14 OTHER THAN AUTO ONLY:
EACH ACCIDENT $ 500,000
AGGREGATE $ 1,000,000
EXCESS LIABILITY EACH OCCURRENCE $10,000,000
A X UMBRELLA FORM 9918175 03/01/13 03/01/14 AGGREGATE $10,000,000
OTHER THAN UMBRELLA FORM 5
WC STATU- CT
WORKERS COMPENSATION AND _ TORY LIMIT ER
EMPLOYERS' LIABIOT"i - - - - - - - - - - - _ . , _ _ -
EL EACH ACCIDENT 4
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT 5
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESISPECIAL ITEMS
CERTIFICATEHOLDER IS AN ADDITIONAL INSURED FOR
GENERAL UABIUTY.
CERTIFICATE HOLDER ' CANCEELATI04.1k.. . .
2781765 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
20E MAIN ST EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ASHLAND OR 97520 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
PRESIDENT
AC01?t) 25-8 t1t9 r1 OACORq CORPORATION Joao