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HomeMy WebLinkAboutInsurance Certificate: Key Manufacturing & Rentals (2) Client#: 175187 KEYMANU ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/25/2016 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 NAOMTACT KC Ferguson Propel Insurance PHO,NE 800 499-0933 Alc, N°): 866 577-1326 ~~c No, Ext): ~F' Medford Workers Compensation I E-MAIL ADDRESS: KC.Ferguson@propelinsurance.con P O Box 936 INSURER(S) AFFORDING COVERAGE NAIC # Medford, OR 97501 INSURER A : SAIF Corporation 36196 INSURED INSURER B Key Manufacturing & Rentals, Inc. INSURER C 18179 SW Boones Ferry Rd. ~ INSURER D : Portland, OR 97224-7672 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 LIMIT LTR INS iR DWV POLICY NUMBER MM/DDNYYY MM/DDIYYYY S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP (Any one person)- $ - PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS i _ NON-OWNED [PROP RTY DAMAGE $ HIRED AUTOS AUTOS _LPer accident - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB ! ' ~ - - - - - CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION 854251 9/0112016 09/01/2017 X PTAT TE EERH AND EMPLOYERS' LIABILITY Y /N ! ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N / A i (Mandatory in NH) E D!SE SE - Ems, El'."FILOYEE $CIN 000 If yes, describe under v DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000 i ~ I I I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E. Main St. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520-1814 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2345723/M2345720 KCFO0