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HomeMy WebLinkAboutInsurance Certificate: S&S Sheetmetal ` A °R°® CERTIFICATE OF LIABILITY INSURANCE 4/21/2o 4 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 endorsemen s . PRODUCER NAMEA CONTCT Susan Wilson, Brown & Brown Northwest PHONE (541) 772-1111 AX Noll (541)772-3785 3256 Hillcrest Park Drive E-MAIL .swilson®bbnw.com INSURER(S) AFFORDING COVERAGE NAIC 8 Medford OR 97504 INSURERA:Allied Group / Nationwide INSURED INSURERB:SAIP Corporation 52412 S & S Sheetmetal Inc. INSURER C: 912 Antelope Road INSURER D: INSURER E White City OR 97503 INSURER F: COVERAGES CERTIFICATE NUMBER CL1442133537 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 ADDL UBR POLICY NUMBER MM/DDY YYY POLICY YEXP YY LIMITS IMIL LTR GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LLABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE OCCUR CP3 00 66117 1e /24/2014 /24/2015 MED EXP(Myone Denson) $ Exclude PERSONAL &ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY ECOMBINED aEt SINGLE LIMIT 1,000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED CP3006611718 /24/2014 /24/2015 BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS gUTOS Per accitlent Hired NonO ned Liabili $ 11000,00 0 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DIED X RETENTION 10,00 CP3006611718 /29/2014 /24/2015 $ F3 WORKERS COMPENSATION WC STATU OTH- ANDEMPLOYERS'LIABILITY --YIN ANY PROPRIETORIPARTNEWEXECUTIVE❑ NIA E.L. EACH ACCIDENT $ 1,000,00 0 OFFICERMIEMBER EXCLUDED? 811929 0/1/2013 10/1/2014 (Mandatory In NH) EL.DISEASE - EA EMPLOYE $ 11000,000 I( yes, describe under DESCRIPTION OF OPERATIONS belcx E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) verification of insurance. Subject to policy termer limits, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE S Wilson, AAI, AIC/SU ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).D1 The ACORD name and logo are registered marks of ACORD