HomeMy WebLinkAboutInsurance Certificate: Phoenix Automotive Center
ACa►RO DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/26/2015
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 endorsements .
PRODUCER CONTACT
NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328 (A/C, No Ext : 888-333-4949 A X No : 507-446-4664
OWATONNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 339-395-6 INSURER B: FEDERATED SERVICE INSURANCE COMPANY 28304
PHOENIX AUTOMOTIVE CENTER INC INSURER C:
PO BOX 519
PHOENIX, OR 97535 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1 REVISION NUMBER: 0
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 NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MM/DD/YYYY MM/DD/YYYY
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100,000
PREMISES Ea occurrence
MED EXP (Any one person)
CLAIMS-MADE X OCCUR
A X BUSINESS OWNER'S LIABILITY N N 9365712 07/01/2015 07/01/2016 PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000
X ]POLICY JECT PRO F] I
LOC
AUTOMOBILE LIABILITY COMBcIiNED SINGLE LIMIT $1,000,000
Ea ac dent
X ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED
B AUTOS AUTOS N N 9365713 07/01/2015 07/01/2016 BODILY INJURY (Per accident)
HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE
IPer accident
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000
A EXCESS LIAB CLAIMS-MADE N N 9365716 07/01/2015 07/01/2016 AGGREGATE $2,000,000
DED RETENTION
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT
OFFICERIMEMBER EXCLUDED? N / A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER CANCELLATION
339-395-6 1 0
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND, OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE 4 ~
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