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HomeMy WebLinkAboutInsurance Certificate: Spring Air Inc 9SPRIAI OP ID: PB Y) CERTIFICATE OF LIABILITY INSURANCE 06/1DATE(MM/6/2016 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). CONTACT PRODUCER Phone: 541-779-4232 N AME: Hart Insurance Fax: 541-772-3963 PHONE FAX 1123 Royal Ave. A/c No Ext : A/c, No Medford, OR 97504 E-MAIL Hart Insurance / Medford ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Cincinnati Insurance 10677 INSURED Spring Air, Inc. INSURER B : SAIF Corp 810 N 5th Street Jacksonville, OR 97530 INSURER C 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 SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X ECP0160324 09/22/2015 09/22/2018 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 CLAIMS-MADE 1:7X1 OCCUR MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,00 RO- LOC $ 7 POLICY X PJECT AUTOMOBILE LIABILITY Ea accident) LIMIT $ 1,000,00 A X ANY AUTO EBA0160324 09122/2015 09/22/2016 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS-MADE ECP0160324 09/22/2015 09/22/2018 AGGREGATE $ 1,000,00 DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY X TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 939696 07/01/2016 07/01/2017 E.L. EACH ACCIDENT $ 1,000,00 N / A OFFICER/MEMBER EXCLUDED? F-1 (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,00 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Ashland is included as additional insured per form GCP204 05/11 CERTIFICATE HOLDER CANCELLATION CITYASH 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 Street AUTHORIZED REP ENTATIVE Ashland, OR 97520 Hart Insura c / Me ord ©1988-2010 ACORD C, PORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD