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Insurance Certificate: Pierce Manufacturing
LAITY RFCC"ER acoRO® CERTIFICATE OF LIABILITY INSURANCE DAT/15/2013 -09/15/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE, CERTIFICATE-HOLDER. THIS CERTIF.ICATE.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--I 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 tlliesnot confer;nghts to the. _ certificate holder in lieu of such endor'sement(s). - • - PRODUCER 1-414-443-0000 CONTACT NAME: Hays Companies of Wisconsin, Inc. PHONE FA% NC NO C. No. Ext) 1200 North Mayfair Road, Suite 100 AE-MAIL DDRESS' Milwaukee, WI 53226 INSURERS AFFORDING COVERAGE NAICY INSURER A: LEXINGTON INS CO 19437 INSURED INSURER B. TRAVELERS PROPERTY CAS CO OF-AMER 25674 Pierce Manufacturing Inc. INSURER C PHOENIX INS CO 25623 P.O. Box 2017 INSURER D: BERKLEY NAIL INS CO 38911 Appleton, WI 54912-2017 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 35707377 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. ILTR TYPE OF INSURANCE iNSR D POLICY NUMBER MMMUrYYYY MMIODYflYYY LIMITS A GENERAL LIABILITY X 015438059 04/01/1 04/01/19 EACH OCCURRENCE $ 1,000,000 X DAMAGE TOR N COMMERCIAL GENERAL LIABILITY PREMIE Ea occurrence) E500, 000 CLAIMS-MADE 000UR MED EXP(Any one person) $Excluded cavra ,ta. .;.0-_ ••L.; a: 1L~.r -i L. -..q r :.,C', PERSONAL SAOV INJURY $1)000,000-' GENERALAGGREGATE'^ $:5;000,000'- GEN'L'AGGREGATE.LIMITAPPLIESPERi-"~~ 1,000,000.. I - - , PRODUGTS~COMPIOP AGG r$ ~ a... X..POLICY- PRQ' LOG r' t. t 179' E `i•t. I IB AUTOMOBILE LIABILITY TJCAP118D2004TIL13 - 10/01/l' COMBINED SINGLE LIMIT r ' Ea acddenl 71 000 000- i 1ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS ' BODILY INJURY (Per oxidant) $ . HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident A X UMBRELLA LIAR X OCCUR 015438060 04/01/1 04/01/14 EACH OCCURRENCE $ 15,000,000 EXCESSLIAR CIAIM$-MADE AGGREGATE $ 15,000,000 DED RETENTIONS $ B WORKERS COMPENSATION TRJUB117D757713 WC STATU- OTH- AND EMPLOYERS' LIABILITY 10/O1/1 10/01/14 % YIN C ANY PROPRIETORIPARTNERI--...E I II NIA TC21NUB117D756513 10/01/1 10/01/14 EL. EACH ACCIDENT $ 1.000,000 OFF,CEWY..E`JEER I-XCWD:Di (Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ 1,000,000 If yas, describe under DESCRIPTION OF OPERATIONS below EL DISEASE- UCY LIMIT $ 1,000,000 D Excess Liability CEX0960017400 04/01/1 04 O1 19 Ea Occ/Agg 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Ramm*s Schedule, it more space Is required) Additional Insured when required by written contract. Two (2) Pierce Dash CIF Pumpere CERTIFICATE HOLDER CANCELLATION 27255-1-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 90 North Mountain Avenue AUTHORIZED REPRESENTATIVE Ashland, OR 975208 0.: USA © 1988-2010 ACORD CORPORATION. All rights reserved, ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD diannewandel 35707377