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HomeMy WebLinkAboutInsurance Certificate: May Rock & Excavating Client#: 176892 MAYROCKI ACORDTM, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/24/2016 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 CONTACT NAME: Nikki Russell Propel Insurance PHONE 800 499-0933 AIC F No A/C, No Ext : 866 577-1326 , Medford Commercial Insurance ADDRESS: nikki.russell@propelinsurance.com P O Box 936 INSURER(S) AFFORDING COVERAGE NAIC # Medford, OR 97501 INSURER A : Cincinnati Insurance Company 10677 INSURED I INSURER B May Rock & Excavating LLC INSURER C : P0Box319 Talent, OR 97540-0319 INSURER D INSURER E : J INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS, IS TO CERTIFY THAT THE POLICIES OF INSUFRA jCE- LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY ` EPP0284114 10/2612016 10/26/201 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY I DAMAGE TO RENTED f PREMISES Ea occurrence $500,000 CLAIMS-MADE a OCCUR i MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC $ JECT A AUTOMOBILE LIABILITY EBA0284114 10/26/2016 10/26/201 EO accden SINGLE LIMIT $1,000,000 X( ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED { BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident 1 i $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY R LIMITS i R ANY PROPRIETOR/PARTNER/EXECUTiVE~ N E.L. EACH ACCIDENT $ - - OFFICER/MEMBER EXCLUDED? !N/A { (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ I If yes, describe under ! DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT is 1 f DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 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 Attn: Mary McClary ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main St. Ashland, OR 97520-1814 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S2446867/M2446614 LABOO