HomeMy WebLinkAboutInsurance Certificate: Star Collision Centers
AGO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
4/26/2016
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 endorsements .
PRODUCER CONTACT
NAME:
YouZoom Insurance Services, Inc PHONE 888_240-8803 FAX 877-835-1833
6900 College Blvd (E-MAIL4 Ext)___ i (A/C, No):
Ste 1000 ADDRESS: AMServiceCenter@arrowheadgrp.com
Overland Park KS 66211 INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA:American Guarantee and Liability In 26247
INSURED STARCOL-01 INSURER B :Zurich American Insurance Company 16535
STAR COLLISION CENTERS, INC INSURER C :
DBA: STAR BODY WORKS, STAR 24HOUR TOWING,
STAR COLLISION CENTER OF ASHLAND, INC. INSURER D
509 WEST MCANDREWS ROAD INSURER E :
MEDFORD OR 97501 INSURER F :
COVERAGES CERTIFICATE NUMBER: 1797273599 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 INSD WVU D !I POLICY NUMBER MM/DD YYYY MM DDYYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY CPO1638679-0 5/1/2016 5/1/2017 EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X i OCCUR
PREMISES (Ea occurrence $100,000
MED EXP (Any one person) $5,000
PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
PRO
POLICY JECT LOC PRODUCTS - COMP/OP AGG $2,000,000
OTHER: $
B AUTOMOBILE LIABILITY CP01638679-0 5/1/2016 5/1/2017 COMBINED SINGLE LIMIT $
(Ea accident) 1,000,000
I
I ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
X AUTOS AUTOS BODILY INJURY (Per accident) $
X NON-OWNED
X HIRED AUTOS PROPERTY DAMAGE AUTOS )Per accident $
$
OCCUR EACH OCCURRENCE $4,000,000
CLAIMS-MADE UMB1638680 0 5/1/2016 5/1/2017
A X EXCESS AB CLAIMSUMBRELLA AB X AGGREGATE $4,000,000
DED IX RETENTION $0 Prod/Comp Op A9 $4,000,000
WORKERS COMPENSATION Y / N PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER__
ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $
(Mandatory in NH) EXCLUDED? ~I N / A E L DISEASE - EA EMPLOYE $
If es, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Garage Keepers GPO1638679-0 5/1/2016 5/1/2017 Limit See Attached Sched
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Garage Keepers includes On-Hook coverage.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF ASHLAND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
90 NORTH MOUNTAIN AVE ACCORDANCE WITH THE POLICY PROVISIONS.
ASHLAND OR 97520
USA AUTHORIZED REPRESENTATIVE
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: Proposal COMMERCIAL AUTO
CA 99371013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GARAGEKEEPERS COVERAGE
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
Named Insured:
Endorsement Effective Date:
SCHEDULE
Location Number Address Where You Conduct Garage Operations Main Location
001 509 WEST MCANDREWS ROAD MEDFORD OR 97501
Coverages Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance INCI,
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 150, 000 Limit Of Insurance
$ 1 000 Deductible For All Perils For Each
Customer's Auto
$ 5, 0 0 0 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
An One Event
Collision $ 150, 0 0 0 Limit Of Insurance I NC L
$ 1 , 0 0 0 Deductible For Each Customer's
Auto
CA 99 371013 Insurance Services Office, Inc., 2011 Page 1
PROPOSAL
Location Number Address Where You Conduct Garage Operations
002 1000 SUMMIT AVE MEDFORD OR 97501
Covera es Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance INCL
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 250, 000 Limit Of Insurance
$ 1, 000 Deductible For All Perils For Each
Customer's Auto
$ 5, 000 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
Any One Event
Collision $ 250, 000 Limit Of Insurance I NC L
$ 1, 000 Deductible For Each Customer's
Auto
Page 2 Insurance Services Office, Inc., 2011 CA 99 371013
PROPOSAL
Location Number Address Where You Conduct Garage Operations
004 1355 SAGE ROAD MEDFORD OR 97501
Cover es Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance INCL
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 200, 000 Limit Of Insurance
$ 1, 000 Deductible For All Perils For Each
Customer's Auto
$ 5, 000 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
Any One Event
Collision $ 200, 000 Limit Of Insurance I NC L
$ 1, 000 Deductible For Each Customer's
Auto
Page 3 Insurance Services Office, Inc., 2011 CA 99 371013
PROPOSAL
Location Number Address Where You Conduct Garage Operations
005 210 GILMORE STREET ROGUE RIVER OR 97537
Covera es Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance INCL
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 200, 000 Limit Of Insurance
$ 1, 000 Deductible For All Perils For Each
Customer's Auto
$ 5, 0 0 0 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
Any One Event
Collision $ 200, 000 Limit Of Insurance I NC L
$ 1, 000 Deductible For Each Customer's
Auto
Page 4 Insurance Services Office, Inc., 2011 CA 99 371013
PROPOSAL
Location Number Address Where You Conduct Garage Operations
006 1119 SOUTH PACIFIC HIGHWAY TALENT OR 97540
Cover es Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance INCL
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 200, 000 Limit Of Insurance
$ 1, 000 Deductible For All Perils For Each
Customer's Auto
$ 5, 000 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
Any One Event
Collision $ 200, 000 Limit Of Insurance I NC L
$ if 000 Deductible For Each Customer's
Auto
Page 5 Insurance Services Office, Inc., 2011 CA 99 371013
PROPOSAL
Location Number Address Where You Conduct Garage Operations
007 1008 OAK STREET MEDFORD OR 97501
Cover es Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance I N C L
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 100, 000 Limit Of Insurance
$ 1 000 Deductible For All Perils For Each
Customer's Auto
$ 5, 0 0 0 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
Any One Event
Collision $ 100, 00C Limit Of Insurance I NC L
$ 1, 000 Deductible For Each Customer's
Auto
Page 6 Insurance Services Office, Inc., 2011 CA 99 371013
PROPOSAL
Location Number Address Where You Conduct Garage Operations
008 715 UNION AVE GRANTS PASS OR 97501
Covera es Limit Of Insurance And Deductible Premium
Comprehensive Limit Of Insurance I N C L
Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For
Loss Caused By Theft Or Mischief
Or Vandalism In An One Event
OR
$ 100, 000 Limit Of Insurance
$ 1, 000 0 0 Deductible For All Perils For Each
' Customer's Auto
$ 5, 000 Maximum Deductible For All
Loss In An One Event
Specified Limit Of Insurance
Causes Of Loss Deductible For Each Customer's
Auto For Loss Caused By Theft Or
Mischief Or Vandalism
Maximum Deductible For Loss
Caused By Theft Or Mischief Or
Vandalism In An One Event
OR
Limit Of Insurance
Deductible For All Perils For Each
Customer's Auto
Maximum Deductible For All Loss In
Any One Event
Collision $ 100, 000 Limit Of Insurance I NC L
$ 1, 000 Deductible For Each Customer's
Auto
Total Premium For All Locations
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Page 7 Insurance Services Office, Inc., 2011 CA 99 371013
PROPOSAL