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HomeMy WebLinkAboutInsurance Certificate: B&B Fire Suppression ® DATE (MM/DD/YYYY) ACC OR" CERTIFICATE OF LIABILITY INSURANCE 12i1i2o16 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 Pam Dressler NAME: Little River Investments PHONE (541) 536-1726 FAX A/C No Ext : A/C, No).- (541) 536-1568 51477 Hwy 97 ADDRIESS: pamObancorpinsurance. com P.O. BOX 327 INSURERS AFFORDING COVERAGE NAIC # 11150 La Pine OR 97739 INSURERA:Arch Insurance Company INSURED INSURER B:SAIF Corp B & B Fire Suppression LLC INSURERC: 823 Columbine Way INSURER D : INSURER E : Central Point OR 97502 INSURER F : COVERAGES CERTIFICATE NUMBER:CL1612120402 REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOb^d HAVE BEEN ISSUED TQ 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED 11000,000 A CLAIMS-MADE ❑ OCCUR PREMISES (Ea occurrence)I~ X MWPK07445406 12/21/2016 12/21/2017 MED EXP (Any one person) $ 51000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY JERCOT El LOC PRODUCTS - COMP/OPAGG$ $ 11000,000 OTHER: AUTOMOBILE LIABILITY (COMBINED OMBINED accident SINGLE LIMIT 1 $ 11000,000 ~ BODILY INJURY (Per person) $ A I ~ ANY AUTO - ALL OWNED X SCHEDULED X MWPK07445406 12/21/2016 12/21/2017 BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS ! Per accident X 19 PIP-Basic $ 15,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 11000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION MWUM07574101 12/21/2015 12/21/2016 $ WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N / A - - - ^,Y835~ AIt 3/1/2Clc DISEASE -EAE.%1?L; rEE ~ 5-0, (Mandatory in NH) ^ ^ G ^v G If yes, describe under DESCRIPTION OF OPERATIONS below ! E.L. DISEASE POLICY LIMIT $ 500,000. ~ ~ III DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder City of Ashland, Oregon and its elected officials, officers and employees are named as Additional Insured. Coverage is primary and non-contributory. CERTIFICATE HOLDER CANCELLATION (541) 488-5311 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Pam Dressler/CLL ©1988-2014 ACORD CORPORATION. All rights reserved. ...o rnn;cforarl marks of r rnpn