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HomeMy WebLinkAboutInsurance Certificate: Kaylor Electric DATE (MM/DD/YYYY) 05/12/2016 A~ CERTIFICATE OF LIABILITY INSURANCE 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: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX HOME OFFICE: P.O. BOX 328 A/c No Ext : 888-333-4949 A/c No): 507-446-4664 OWATONNA, MN 55060 E-MAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 343-086-5 INSURER B: FEDERATED SERVICE INSURANCE COMPANY 28304 KAYLOR ELECTRIC LLC INSURER C: PO BOX 639 PHOENIX, OR 97535 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13 REVISION NUMBER: 0 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DDIYYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $100,000 X BUSINESS OWNER'S LIABILITY MED EXP (Any one person) A N N 9118896 07/01/2016 07/01/2017 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ❑ EPRO- CT ❑ LOC PRODUCTS - COMPIOP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED B AUTOS AUTOS N N 9118897 07/01/2016 07/01/2017 BODILY INJURY (Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident) UMBRELLA LIAB HOCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION WORKERS COMPENSATION OTH- PER STATUTE ER AND EMPLOYERS' LIABILITY Y / N ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATEHOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESSOWNERS LIABILITY. CERTIFICATE HOLDER CANCELLATION 343-086-5 130 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND, OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD FEDEXATED INSURj4NCEqF@ To Whom It May Concern, RE: KAYLOR ELECTRIC LLC Enclosed is a certificate of insurance that has been renewed for a new policy term. If a copy of an additional insured or policy endorsement was requested, the document will be sent in a separate envelope. If you have any questions regarding this please contact: the Federated Insurance Client Contact Center at: Phone: 1-888-333-4949 Fax: 507-446-4664 E-mail: clientcontactcenter@fedins.com Thank you, Client Contact Center Federated Insurance Companies Enclosed: Certificate of Insurance MISC-0974 (04-13)