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HomeMy WebLinkAboutInsurance Certificate: Keller Associates KELLE-4 OP ID: JY ,A~Co~RO CERTIFICATE OF LIABILITY INSURANCE 71TE2/1(M7/2015MIDDfYYYY) 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: JererllyKrOII - Cal PHONE The Hartwell Cor Poration - FAX 208 454-1114 PO Box 400 (A/C. No, E.t : 208-459-1678 --LC,. NoJ: _ Caldwell, ID 83606 AE-MAIL DDRESS: Jeremy Kroll - - INSURER(S) AFFORDING COVERAGE _ NAIC # INSURER A : Travelers Indemnity Co 25666 INSURED Keller Associates, Inc. INSURER B : Travelers Indemnity_ of CT 25682 131 SW 5th Ave, Ste A INSURER Meridian, ID 83642 INSURER c :Travelers Casualty and Surety _ 31194 INSURER D:XL Specialt~r Insurance Co. 37885 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. - _ ADDL SUB POLICY EFF -POLICY EXP TR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS I F_ A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH Toccu Eence $ $ 11,,000000,00 ;-T [11 DAMAGE( RENTED J CLAIMS-MADE OCCUR X 6807877L118 1210112015 12/01/2016 PREMISES X CGD381 MED EXP (Any one person) $ 10 000 X CGD 379 PERSONAL & ADV INJURY $ - 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER - GENERAL AGGREGATE $ - 21000,000 RO- T LOC PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY jEC OTHER AUTOMOBILE LIABILITY COMBINED SINGLtE LIMIT I $ 1,000,000 - X gA78771_468 12/01/2015 12/0112016 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON-OWNED PROPERTY DAMAGE $ r acciden_ _X HIRED AUTOS AUTOS X CAT353 Pe $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAR CLAIMS-MADE CUP-8961X179 12/01/2015 12/01/2016 AGGREGATE $ 4,000,000 T D 10000 ED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY i 12/01/2016 E.L EACH AC 1,000,00 C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN '',UB9722YO81 12/01/2015 E, SEAT AC 1CIDENT L FOR H (OFFICER/MEMBER EXCLUDED? FN ]I N / A _ .,000,000 TOP GAP 1~l01.2015 12/01/2016 (Mandatory in NH) WA $r WY S. C.L s 1SE - E L PLOYLE $ 7 It y es, describe under E.L DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below / I 0 D PLiability DPR9800553 12/01/2015 12/01/2016 'Ea Claim 2,000,00 $100,000 deductibl Annl Aggr 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ASHAS-2 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. 20 East Main St. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD