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HomeMy WebLinkAboutInsurance Certificate: Quality Fence Co 9QUALFE OP ID: KD ,d►coRn CERTIFICATE OF LIABILITY INSURANCE DATE (29/20Y5 0912912015 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). CONT PRODUCER Phone: 541-779-4232 NAMEACT Hart Insurance Fax: 541-772-3963 a~"N EXt j~FAX L---- - 1123 Royal Ave. E-MAIL - - - - AIC, No ; Medford, OR 97504 ADDRESS:--. Hart Insurance / Medford INSURER(S) AFFORDING COVERAGE NAIC tt INSURERA:SAIF Corp INSURED Quality Fence Co. INSURER B : dba: Reliable Electric INSURERC: P.O. Box 3985 . Central Point, OR 97502-3985 _INSURER D.' INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS 1-0 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. - DDL SUBR POLICY EFF POLICY EXP INS ILTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE E-] OCCUR MED EXP (Any one person) $ - PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER I PRODUCTS - COMPIOP AGG $ - POLICY PRO- $ LOC JECT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED f SCHEDULED BODILY INJURY (Per accident) $ _ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident) - UMBRELLA LIAB OCCUR EACH OCCURRENCE - $ _±A EXCESS LIAB CLAIMS-MADE AGGREGATE _ _ $ DED RETENTION $ $ OTH- WORKERS COMPENSATION X WC TORY STATU- LIMITS ER AND EMPLOYERS' LIABILITY YIN ~ 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N / A 738638 10101/2014 10/01/2015 r L. EACH ACCIDENT c OFFICER/Mry in N EMBER EXCLUDED? 738638 10101/2015 10/01/2016 EL DISEASE - EA EMPLOYEEI $ 500,00 (Mandato yes, describe under F---- OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Hart Insurance / Medford ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD