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HomeMy WebLinkAboutInsurance Certificate: Key Manufacturing & Rentals Inc KEYM01C OP ID: CDS Y) DATE CERTIFICATE OF LIABILITY INSURANCE 03/31/2015 03/31 /2015 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 NAME: CT Cindy Sorensen United Risk Solutions, Inc. PHONE FAX PO Box 936 A/C No Ext :541-245-1111 A/C, No): 541-245-1112 Medford, OR 97501-0067 E-MAIL SS: cindy.sorensen@unitedrisk.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Mutual of Enumclaw 14761 INSURED Key Manufacturing INSURER B: & Rentals Inc. 18179 SW Boones Ferry Rd. INSURER c Portland, OR 97224-7672 INSURER D : 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 SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY _1M& WVD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X X CPP001097003 04/01/2015 04/01/2016 DAMAGE TO RENTED 1,000,000 PREMISES Ea occurrence $ CLAIMS-MADE ~ OCCUR MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY 1-1 jECT [7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ A X ANY AUTO CPP001097003 04/01/2015 04/01/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS PER ACCIDENT L - $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 A X EXCESS LIAB CLAIMS -MADE UM0000211203 04/01/2015 04/01/2016 AGGREGATE $ 1,000,00 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ _ A Inland Marine CPP001097003 04/01/2015 04/01/2016 Ded. 2,50 Equipment Rent/Leas 100,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Ashland, Oregon and its elected officials, officers and employee are additional insured with primary and non-contributory coverage including a Waiver of Subrogation per forms CG2026 07/04 and CG2404 05/09. Cancellation Clause IL 0279 09/08 included. CERTIFICATE HOLDER CANCELLATION CITAS03 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. 20 E. Main St. Ashland, OR 97520-1814 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD