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HomeMy WebLinkAboutInsurance Certificate: Ashland Medford Plumbing A~ ® DATE 1M1 CERTIFICATE OF LIABILITY INSURANCE 02/03/2017 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 NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX HOME OFFICE: P.O. BOX 328 A/C No Ext : 888-333-4949 A/C No : 507-446-4664 OWATONNA, MN 55060 E-MAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 358-611-2 INSURER B: ASHLAND MEDFORD PLUMBING INC INSURER C: PO BOX 8494 MEDFORD, OR 97501 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 124 REVISION NUMBER: 0 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED $100,000 PREMISES Ea occurrence MED EXP (Any one person) EXCLUDED A N N 9337481 03/20/2017 03/20/2018 PERSONAL & ADV INJURY $13000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ❑ PRO- ❑ LOC PRODUCTS - COMP/OP AGG $2,000,000 JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY (Per person) ALL OWNED SCHEDULED A AUTOS AUTOS N N 9337481 03/20/2017 03/20/2018 BODILY INJURY (Per accident) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000 A EXCESS LIAB CLAIMS-MADE N N 9337482 03/20/2017 03/20/2018 AGGREGATE $2,000,000 IDED RETENTION STATUTE OTH- WORKERS COMPENSATION PER ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? N/A E.L. DISEASE EA EMPLOYEE (Mandatory in NH) If yes, describe under E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION 358-611-2 1240 CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND, OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD BWNDHBS 358-611-2124 XWXW0021 XXXXXXX5# R6007-06 - 0211 CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1814 FEDEMTED IINSURANCEqF@ To Whom It May Concern, RE: ASHLAND MEDFORD PLUMBING INC Enclosed is a certificate of insurance that has been renewed for a new policy term. If a copy of an additional insured or policy endorsement was requested, the document will be sent in a separate envelope. If you have any questions regarding this please contact: the Federated Insurance Client Contact Center at: Phone: 1-888-333-4949 Fax: 507-446-4664 E-mail: clientcontactcenter@fedins.com Thank you, Client Contact Center Federated Insurance Companies Enclosed: Certificate of Insurance M I SC-0974 (04-13)