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HomeMy WebLinkAboutInsurance Certificate: Key Manufacturing & Rentals ~-1 KEYM01 C OP ID: EKC ACORO CERTIFICATE OF LIABILITY INSURANCE 0 D3/31/201YY) 03/31/2016 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 NCONTACT AME: Cindy Sorensen Propel Insurance PHONE FAX formerly United Risk Solutions A/C No,EXt):541-245-1111 541-24.5-1112 PO Box 936 EE-M Be Medford, OR 97501-0067 ss: Cindy.sorensen@propelinsurance.com John A. Huggins INSURER(S) AFFORDING COVERAGE NAIC_ INSURER A : Western National Assurance Co 4465 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 SUBRI POLICY NUMBER MY/YYEFF YY MMIDDYIYYEXP YY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 RENTED - A ~X COMMERCIAL GENERAL LIABILITY X X CPP113584200 04/01/2016 04/01/2017 DAMA ET PREMISES Ea occurrence) $ 1,000,00 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO- F LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident) $ A X ANY AUTO CPP113476800 04/01/2016 04/01/2017 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PPROP ER ERTY DAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 A X EXCESS LIAB r CLAIMS-MADE UMB102241500 04/01/2016 04/01/2017 AGGREGATE g 1,000,000 DED X RETENTION $ 10,000, $ WORKERS COMPENSATION WC STATU- OTH-, AND EMPLOYERS' LIABILITY tEL. LI MITS ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ ACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A', I I (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ - "yes deccribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A (Inland Marine CPP113587600 04/01/2016 04/01/2017 !Ded. 2,500 Equipment Rent/Leas 25,000 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 as required by written contract. 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. 20 E. Main St. Ashland, OR 97520-1814 AUTHORIZED REPRESENTATIVE &&A W* ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD