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HomeMy WebLinkAboutInsurance Certificate: American Leak Detection BOTEINC-01 D1 SKAMBUROFF A~'ORQ DATE (MMlDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 0611312017 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 LICenSe # 954553 NAMEACT Dawson Franchise Insurance Division alco"No, Ext 800 860-0090 FAx 440 356-2126 3900 Kinross Lakes Parkway #300 EMAIL ~ ~ (AIC, No):( Richfield, OH 44286 ADDRESS: franchisecerts@dawsoncompanies.com INSURER S AFFORDING COVERAGE NAIC # INSURERA:CInClnnatl Insurance Com an 10677 INSURED INSURER B Boterman's Inc. dba American Leak Detection INSURER C 2821 Bullock Road INSURER 0 Medford, OR 97504 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2'000'000 CLAIMS-MADE ~ OCCUR EPP 0393352 0710112016 0710112017 DAMAGE TO RENTED 300,000 PREMISES Ea o currence $ MED EXP An one erson $ 10'000 PERSONAL & ADV INJURY $ 2'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4'000'000 POLICY ~ PRO ❑ LOC PRODUCTS - COMPIOP AGG $ 4'000'000 JECT OTHER: A AUTOMOBILE LIABILITY EOMBINdeDtSINGLE LIMIT $ 1,000,000 X ANY AUTO EPP 0393352 0710112016 0710112017 BODILY INJURY Per erson $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED Pe~accidenlDAMAGE $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS' LIABILITY TAT TE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~ E.L. EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? N I A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ I' yes, describe under j DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) ©1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD