Loading...
HomeMy WebLinkAboutInsurance Certificate: Twedells Automotive Towing & Wrecking TWEDE-1 OP ID: RODO DATE (M MIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/08/2015 TH/S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CF.RTIFICATE 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). NAME: ONTACT Donna Rova PRODUCER C Columbia Insurance Group PHONE i FAX I 911 Country Club Rd, Ste 270 A/C No, EXt .541-687-1915 (A/C, No): 541-687-0277 - - Eugene, OR 97401 E-MAIL ADDRESS: donna@columbiainsgroup.com _ Donna ROVa INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Markel Insurance Company - INSURED Twedell's Automotive, Towing & INSURER B : Oregon Mutual Ins. Co. Wrecking, Inc wsURER C : - 3116 N Pacific Highway INSURER D : Medford, OR 97501 - 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. ADDL SUBR POLICY EFF POLICY EXP WVD ILTR TYPE OF INSURANCE IINSR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - ! DAMAGE TO 'LN I LU A X COMMERCIAL GENERAL LIABILITY PTOWK0091 11 -00 01/02/2017 01/02/2018 PREMISES (Ea occurrence) $ 100,00 CLAIMS-MADE " OCCUR MED EXP (Any one person) $ _ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 J II I, G EN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMP/OP AGG $ 1,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ A ANY AUTO PTOWK0091 11 -00 01/02/2017 01102/2018 BODILY INJURY (Per person) $ ALL OWNED X SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON PROPERTY DAMAGE -OWNED PER ACCIDENT) _ AUTOS $ - - 7 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER - ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEES $ LIf yes, describe under E.L. DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A On Hook/Cargo PTOWK009111-00 01/02/2017 01/02/2018 ided $1000 $60x7 150x2 A IGaragekeepers PTOWK0091 11 -00 01/02/2017 01/02/2018 ;Ided $1000 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION AS H LA-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland Police Department ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD TWEDE-1 PAGE 2 NOTEPAD INSURED'S NAME Twedell's Automotive, Towing & OP ID: RODO Date 01/08/2015 ;.ocations: I's116 N Pacific Hwy Medford, OR 97501 15 Ehnman Way Medford, OR 97501 1242 Bens Ln Medford, OR 97501 1311-1314 S Pacific Hwy Talent, OR 97540 Vehicles: 1992 Chevy 81151 1988 Intn'l 92637 2004 Ford 52849 2001 Sterlin 18512 2000 Ford 27691 2004 Intn'l 56972 1999 Intn'l 81239 2008 Ford 29002 2007 Ford 66091 VCERTIFICATE /06/2017 09:46 541-687-0277 AMERICAN INSURANCE PAGE 01/02 DE-1 OP ID: RODO In CERTIFICATE OF LIABILITY INSURANCE 0 D 1108/2015 01/08/2015 ERTIFICATE 19 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CEFICATE HOLDER. THIS DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFO ED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AN13 THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATI IS WAIVED, subject to the terms and conditions of the policy, cenaln policies may require an endorsement_ A statement on this certificate d not confer rights to the certificate holder in lieu of such endolsemen 5 . PRODUCER CONTACT NAME: Donna Rova Columbia Insurance Group PRONE 911 Country Club Rd, Ste 270 ac Nn Fxt :641-687-1915 No,; 641-687-0277 Eugene OR 97401 ADDRESS: donna columblaine rou .corn Donna Nova INSURER(S) AFFORDING COVERAGE NAIC p INSURERA : Markel Insurance Compan _ INSURED TWedell's Automotive, Towing & INSURER e : Oregon Mutual Ins. CO. Wrecking, Inc IN9URERC: 3116 N Pacific Highway Medford, OR 97501 INSURER D INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUM R: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV OR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH ESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SU CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE IN POLICY NUMB! MWD EXP D/YYY JMWDDJYY" LIMITS GENERAL LIABILITY EACH OCCURRENC $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY PTOWK009111-00 0110212017 0110212018 PREMISES Ea ocau ce $ 100x00 CLAIMS-MADE ~ OCCUR MED EXP (Any one on) $ 6x40 PERSONAL & AOV I RY S 1,000,00 GENERAL AGGREG $ 3,000,00 nx N1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP AGO $ 1,000,00 RO LOC $ PO LICY P JPCT AUTOMOBILE LIABILITY COMBINED SINGLE IT 1,000,000 Ea accldenl S A ANY AUTO PTOWK009111-00 01/0212017 01102/2018 BODILY INJURY (Pe rson) S ALL OWNED X SCHEDULED BODILY INJURY (Pe id6M) $ NON-OWNED PROPER TY DAMA $ x HIRED AUTOS x AUTOS PER ACCIDENT $ UM"L.LA LIAR OCCUR EACH OCCURRENC $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY T --ER ANY PROPRIETORIPARTNER/EXECUTIVE YIN E.L. EACH ACCIDEN $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L. DISEAS_E_- EA E LOYEE $ If yes describe under DE IPTION OF OPERATIONS ba)ow E.L. DISEASE - POLI LIMIT S q On Hook/Cargo PTOWK009111-00 01/0212017 01/02/2018 ded $1000 $60x7 150x A Garagekeepers PTOWK009111-00 01/0212017 01/02/2018 ded $1000 500,00 DESCWPTION OP OPERATIONS I LOCATIONS / VEHICLES (AMacn ACORD 101, Additional Remarks 6cneouie, if more space Is required) CERTIFICATE HOLDER CANCELLATION ASHLA-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICI BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE ILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS- 541-488-5320 90 N. Mountain Ave AUTHG=ED REPRESENTATIVE Ashland, OR 97520 ®1988.2010 ACORD CORPORATI 14. All rights reserved. ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD 01/06/2017 09:46 541-687-0277 AMERICAN INSURANCE PAGE 02/02 NOTEPAD TWEDE-1 PACE 2 INSUREWS NAME Twedell's Automotive, Towing & OP ID: RODO Dale 0110812016 Locations: 3116 N Pacific Hwy Medford, OR 97501 15 Ehnman Way Medford, OR 97501 1242 Sens Ln Medford, OR 97501 1311-1314 8 Pacific Hwy Talent, OR 97540 vehicles: 1992 Chevy 81151 1998 Intn' 1 92 637 2004 Ford 52849 2001 Sterlin 18512 2000 Ford 27691 2004 Intn'l 56972 1999 Intn'l 81239 2008 Ford 29002 2007 Ford 66091