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HomeMy WebLinkAboutInsurance Certificate: Cutting Edge Restoration U14-06-04 13:48 The Insurance Center 5418999532 541 488 5320 P 1/1 L.U 111-1 UP, ILI: b W CORD' CERTIFICATE OF LIABILITY INSURANCE oDAT E(MWOo a ) .-HIS 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 endorsement(s). PRODUCER CNANEAcT George Wheeler The 240 West "C Streeter, Inc- PHONE Sent, 541-899-9535 I Np: 541-899-9532 P O Box 6 E4%AIL Jacksonville, OR 97530 ADDRESS` George Wheeler INSD 9 AFFORDING COVERAGE NAICS INSUMRA:Develo ers Sure& Indemnity INSURED Cutting Edge Restoration INSURERe:Ore on Mutual Ins. 14907 David Geigle INSURER C:Insco Dico PO Box 782 Jacksonville, OR 97530 INSURERD: 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 ADDL SUBS POLICY EPP POLICY EXP LTR POLICY NUMBER N (11"kDowym LIMITS DIED JNM A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,00 PCIOCCUR BIS00014726-02 0112812014 0112812015 PREMISE Eaocuaence S 300,00 MED EXP Anone parson) S 5,00 PERSONAL S ADV INJURY 3 500,00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 1,000,00 POLICY 0 PROJECT- F7 LOC PRODUCTS - COMP/OPAGG S 1,000,00 OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 3 Ea awdent B ANY AUTO P703633 10/0112013 1010112014 BODILY INJURY (Per person) 3 50,00 ALL UTOS~ED SCHEDULED BODILY IWURY(For a deM) S 100,00 X A NON-OWNED PROPERTY DAMAGE g 25,00 HIREDAUTOS AUTOS Per secdeM 3 UMBRELLA LUIS OCCUR EACH OCCURRENCE S 6XCE88 LIAR CLAIMS-MADE AGGREGATE 3 DED RETENTION 3 WORKERS COMPENSATION PER OTH- M13 EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUOED7 F-1 NIA (Mandatory In NHl E.L DISEASE - FA EMPLOYEE S a yea, tlaavlbo uMer DESCRIPTION OF OPERATIONS bel. E.L DISEASE - POLICY LIMIT 3 C Surety Bond 252307C 01/20/2014 0112012015 RGC 20,00 DESCRIPTION OP OPEMrI S I LOC MONS I VEHICLES (pCORD 101, Addltlelltl Remake BaNMuIA mry IB eBaahsd H nmra y,eee la raqulratl) CCB license 9194900 1 CERTIFICATE HOLDER CANCELLATION CITYASH 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. Attn: Gayle Peters 90 N. Mountain Ave. AUTHORED REPRESENrarlvE Ashland, OR 97520 George Wheeler © 19 S- CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered ma s of ACORD