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HomeMy WebLinkAboutInsurance Certificate: May Rock & Excavating MAYR01C OP ID: HSA ACORO CERTIFICATE OF LIABILITY INSURANCE 7,TEO/27/2015(MM/DDIYYYY) 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: Holly Avritt United Risk Solutions, Inc. PHONE FAx PO Box 936 ac No El :541-245-1111 (AJC No): Medford, OR 97501-0067 EMAIL ADDRESS: holly.avritt@unitedrisk.com INSURER(S) AFFORDING COVERAGE _ NAI_C # INSURER A: The Cincinnati Insurance 10677 INSURED May Rock & Excavating LLC INSURER B : P O Box 319 Talent, OR 97540-0319 INSURERC: 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. - - - - - - - - - ILTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MMLDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000 A X COMMERCIAL GENERAL LIABILITY EPP0284114 1!, 10/26/2015 10/26/2016 F DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,00 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 10,00 LA] $ 1,000,000 T !~I', GENERALAGGREGATERY I'1 $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER '.1 PRODUCTS COMP/OP AGG $ 2,000,000 X 'POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ii AEa accident) 1,000,000 X 10/26/2016 1 BODILY INJURY (Per person) $ ALL AUTOS iEBA0284114 10/26/2015j BODILY INJURY (Per - accident), $ A OWNED ANY O F SCHEDULED - - NON-OWNED PROPERTY DAMAGE , ~I HIRED AUTOS AUTOS (PER ACCIDENT) $ f _ - UMBRELLA LIAB ' OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE 1 DED RETENTION $ WORKERS COMPENSATION WC STATU- 0TH AND EMPLOYERS' LIABILITY YICI TORY LIMITS -ER ANY PROP R I ETOR/PARTNER/EXEC UTIVE FFICER///M in NH) EXCLUDED? ~ N / A ELSE ACCIDENT EMPLOYEE $ (Mandatory . ) $ _ DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $ i 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITAS03 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: Mary McClary 20 E. Main St. AUTHORIZED REPRESENTATIVE Ashland, OR 97520-1814 © 1988-20100 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD