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HomeMy WebLinkAboutInsurance Certificate: Metal Masters Inc METAL-1 OP ID: KIY D Y) CERTIFICATE OF LIABILITY INSURANCE 1010212013 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 endorsements . PRODUCER Phone: 541-773-5358 NAMEACT Kendall Yeaw Protectors Insurance, LLC PHONE FA% Pilot Rock Ins Agency LLC (CA) Fax: 541-772-1906 Arc No E,1,541-842-2963 Alc No:541-772-1906 PO Box 4669 E-MAIL kendall rotectorsins.com Medford, OR 97501 ADDRESS: Dennis C. Flenner INSURERS AFFORDING COVERAGE NAIC N INSURER A: American Fire and Casual INSURED Metal Masters Inc INSURER a: Ohio SeCurl Insurance 3825 Crater Lake Hwy INSURERC:Ohio Casual Insurance Medford, OR 97504 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 A POLICY NUMBER MMIDDIIYYYY MMIDDrYYXYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BKA55281530 1010112013 1010112014 PREMISES Ea occurrence $ 1,000,00 CLAIMS-MADE FXIOCCUR MED EXP (Anyone 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 $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident B X ANY AUTO BASS5281530 10/0112013 10/01/2014 BODILY INJURY (Per Person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 C EXCESS LIAB CLAIMS-MADE US055281530 10/0112013 1010112014 AGGREGATE $ 2,000,00 DED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMIT D ANY PROPRIETOWARTNERIEXECUTIVE YIN 812256 1010112013 1010112014 E.L. EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? ~ NIA (Mandatory In NH) E.L. DISEASE -EA EMPLOYEE $ 1,000,00 If yes, describe under DE SCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) As additional insured per policy endorsement CG8811(1009): CERTIFICATE HOLDER CANCELLATION CITYASH 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. City Hall Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Dennis C. Flenner © 1988-2010 ACORD CORPORATION. All rights reserved. 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