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HomeMy WebLinkAboutInsurance Certificate: Star Collision Centers (2) 'ACS 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 (A/C, No, Ext): i (A/C, No): Ste 1000 E-MAIL AMServiceCenter@arrowheadgrp.com Overland Park KS 66211 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:American Guarantee and Liability In 126247 INSURED STARCOL-01 INSURER B:Zurich American Insurance Company 16535 STAR COLLISION CENTERS, INC INSURERC: 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: 2066587007 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 ADDCISUBR'I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y CPO 1638679-0 5/1/2016 5/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) I $5,000 I PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $2,000,000 I POLICY I JECT I L PRO LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT CP01638679-0 5/1/2016 5/1/2017 Ea accident) $1,000,000 ANY AUTO BODILY INJURY (Per person) $ X ALL OWNED SCHEDULED L_ AUTOS ALL BODILY INJURY (Per accident) $ O S : HIRED AUTOS X NON-OWNED X AUTOS PROPERTY DAMAGE I (Per accident) $ A X UMBRELLA LIAB X OCCUR UMB1638680-0 5/1/2016 5/1/2017 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MAD( AGGREGATE $4,000,000 DED X RETENTION $0 Prod/Comp Op A $4,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A I (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under - - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Garage Keepers i CPO 1638679-0 5/1/2016 5/1/2017 Limit See Attached Sched 1 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 is named as an Additional Insured. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 EAST MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. 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 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, 0 0 0 Limit Of Insurance $ 1, coo 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 An One Event Collision $ 150, 000 Limit Of Insurance INCL $ 1, 000 Deductible For Each Customer's Auto CA 99 371013 Insurance Services Office, Inc., 2011 Page 1 PROPOSAL Location Number Address Where You Conduct Gar e Operations 002 1000 SUMMIT AVE MEDFORD OR 97501 Covera es Limit Of Insurance And Deductible Premium Comprehensive Limit Of Insurance I NC 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 $ 250, 000 Limit Of Insurance $ 1 0 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 E$ 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 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 $ 20C, 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 RI=VER 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 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 E$ 200, 000 Limit Of Insurance INCL $ 1 , 0 0 0 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 Customers 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 N C L $ 1, 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 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 $ 10c, 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 $ 100, 0 0 0 Limit Of Insurance I N C 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 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 $ 100, 0 0 0 Limit Of Insurance $ 1, 000 Deductible For All Perils For Each Customers Auto $ G , 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 E$ 100, 000 Limit Of Insurance INCL $ 11 000 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