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HomeMy WebLinkAboutInsurance Certificate: Kaylor Electric LLC D @ DATE (MM/DD/YYYY) A~ CERTIFICATE OF LIABILITY INSURANCE 05/11/2017 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 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 ri hts to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 A CNNo Ext :888-333-4949 A C No :507-446-4664 OWATONNA, MN 55060 EMAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM INSURERS) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 343-086-5 INSURER B: FEDERATED SERVICE INSURANCE COMPANY 28304 KAYLOR ELECTRIC LLC INSURER C: PO BOX 639 INSURER D: PHOENIX, OR 97535-0639 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM1DDlYYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000+000 DAMAGE TO RENTED $100,000 CLAIMS•MADE ~ OCCUR PREMISES Ea occurrence X BUSINESS OWNER'S LIABILITY MED EXP (Any one person) A N N 9118896 07/01 /2017 07/01/2018 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO ❑ LOC PRODUCTS • COMPIOP AGG $2,000,000 X JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY (Per person) SCHEDULED B OWNED AUTOS ONLY AUTOS N N 9118897 07101/2017 07/01/2018 BODILY INJURY (Per accident) NON-OWNED PROPERTY DAMAGE HIRED AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS•MADE AGGREGATE DED RETENTION WORKERS COMPENSATION PER STATUTE OTH- ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNERIEXECUTIVE ❑ E.L. EACH ACCIDENT OFFICERlMEMBER EXCLUDED? N I 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 f LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATEHOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESSOWNERS LIABILITY, CERTIFICATE HOLDER CANCELLATION 343-086-5 13 0 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD FEDER~ITED INSURANCE~° To Whom It May Concern, RE: KAYLOR ELECTRIC LLC 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 MISC-0974 (04-13)