HomeMy WebLinkAboutInsurance Certificate: Kaylor Electric
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'ihwee~ CERTIFICATE OF LIABILITY INSURANCE c; 0523/05/23/2013
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(les) 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 endorsements .
PRODUCER NOANTACT C NT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX
HOME OFFICE: P.O. BOX 328 A/c Me Exl : 888-3334949 A/c No l: 507-446-4664
OWATONNA, MN 55060 ADDRESS: CLI ENTCONTACTCENTER FEDINS.COM
INSURERS) AFFORDING COVERAGE NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 343-086-5 INSURER e: FEDERATED SERVICE INSURANCE COMPANY 28304
KAYLOR ELECTRIC LLC INSURER C:
PO BOX 639
PHOENIX, OR 97535 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 13 REVISION NUMBER: 0
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 DL SUER pOL1CY NUMBER MMIDD POLICY I YVV EFF PODGY E%P MM/DDIV YY LIMITS
TR INS WVD
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
$50,000
COMMERCIAL GENERAL LIABILITY PREMISES Ea cairrenm
MED EXP (AAy. person) $5,000
CLAIMS-MADE X OCCUR
A X BUSINESS OWNER'S LIABILITY N N 9118896 07/01/2013 07/01/2014 PERSONALS ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $2,000,000
X ]POLICY jECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
cdden
X ANY AUTO BODILY INJURY (Per person)
ALL OWN ED SCHEDULED
B AUTOS AUTOS N N 9118897 07/012013 07/012014 BODILY INJURY (Per accident'
HIRED AUTOS NON-OWNED PROPERTY DAMAGE
AUTOS (PROPER
..6
UMBRELLA LIAR OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE
DIED RETENTION
WORKERS COMPENSATION WC STATUS OTH-
AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER
E.L. EACH ACCIDENT
ANY PROPRIETOR/PARTNERIEXECUTIVE "NIA
OFFICERIMEMBER EXCLUDED? (Manclatory In NH) E.L DISEASE - EA EMPLOYEE
II yes, describe under
DESCRIPTION OF OPERATIONS below El DISEASE -POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (AKatll ACORD 101, Additlonal Asnieres Schedule, it more space is required)
CERTIFICATEHOLOER IS AN ADDITIONAL INSURED SUBJECT TO THE
CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
FOR BUSINESSOWNERS LIABILITY.
CERTIFICATE HOLDER CANCELLATION
343-086-5 130
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND, OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1908.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD