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HomeMy WebLinkAboutInsurance Certificate: Pressure Point Roofing (3) ® DATE (MM/DD/YYYY) ACRD CERTIFICATE OF LIABILITY INSURANCE 11/03/2016 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 have ADDITIONAL INSURED provisions or 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: Misty D Whorley Hart Insurance Agency - Medford PHONE FAX PO Box 1240 A/C No Ext: (541) 779-4232 A/C No: E-MAIL ADDRESS: Grants Pass OR 97528 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Specialty Underwrit INSURED (541) 772-1945 INSURERB: SAIF Corporation Pressure Point Roofing Inc. INSURER C: Mutual of Enumclaw Insurance C 14761 5235 Rainbow Dr INSURER D : Central Point OR 97502 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: Cert ID 1725 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 INSD WVD POLICY NUMBER MM/ DIYYYY MM LTR / DNYYY LIMITS A X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR Y Y CSU0068454 103/29/2016 03/29/2017 PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 11000,000 GENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 JECT F7x OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 C X ANY AUTO Y CPP0002914 12/06/2016 12/06/2017 BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR CSU0068455 03/29/2016 03/29/2017 EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION $ $ PER B AND EMPSLOYYERSERS'' LIABILITY AYIN 945959 10/01/2016 10/01/2017 STATUTE ER H AND EMP ji ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 11000,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $ 11000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holders are included as Additional Insured per attached form CSGA4031 (06/12) Waiver of Subrogation per form CSGA4087 (12/12) Completed Operations included, Coverage is Primary & Non-Contributory per written contract CERTIFICATE HOLDER CANCELLATION 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 REPRESENTATIVE Ashland OR 97520 cl ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Page 1 of I