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HomeMy WebLinkAboutInsurance Certificate: American Industrial Door (2) AMERIND-03 PHITE ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 0"14 Y) 6/23/2014 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 endorsement(s). PRODUCER CONTACT NAME: Medford Office PHONE FAX PayneWest Insurance, Inc. A/c No Eat:(641) 779-1321 ac No: (541) 779-9187 38 North Central Ave. E-MaL ADDRESS: Medford, OR 97501 INSURER(S) AFFORDING COVERAGE NAIL s INSURER A: Western National Assurance Co 24465 INSURED INSURER B : American Industrial Door LLC; American Industrial Door Co. INSURER C: 5022 Table Rock Rd. INSURER D: Central Point, OR 97502 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 POLICY NUMBER MM/DD/YYW MM/DDIIYYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE N OCCUR X CPP1059502 06/23/2014 06123/2015 PREMISES Ea occurrence) $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY JECT L] LOC PRODUCTS - COMP/OP AGG $ 2,000,00 OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ee eccitlenf A X ANY AUTO X CPP1058471-02 0612312014 06/23/2015 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Peracci0enp $ AUTOS AUTOS NON-OMED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ J( UMBRELLA LIAB X OCCUR EACH OGCURRENCE $ 2,000,00 A EXCESS LIAB CLAIMS-MADE UMB1009693-02 0612312014 06123/2015 AGGREGATE $ 2,000,00 DED X RETENTIONS 10,000 Is WORKERS COMPENSATION PER OTH- AND EMPLOYERS LIABILITY YIN _ STATUTE ER ANY PROPRIETORMARTNERVEXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E. L. DISEASE - EA EMPLOYEE $ If yes, desc,ibe unoe, DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is require l D RE: 2013 Slurry Seal Project #2013-10 i JUN 3 0 2014 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E. Main St. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE P A4 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD