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HomeMy WebLinkAboutInsurance Certificate: Pape Machinery, Inc DATE (MM/DD/YYYY) AC"RO® CERTIFICATE OF LIABILITY INSURANCE 02/28/2018 16-~ " 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 CONTACT MARSH USA INC. NAME: PHONE FAX 111 SW COLUMBIA, STE. 500 no. Extia A/C No : PORTLAND, OR 97201 E-MAIL Attn: Amy Shafer 503-248-4857 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # CN101920225-STND-GAWU-18-19 PMACH INSURER A : National Union Fire Insurance Company 19445 IN PAPS MACHINERY, INC. INSURER e : N/A NIA C/O THE PAPE' GROUP INSURER C : N/A N/A PO BOX 407 INSURER D : N/A N/A EUGENE, OR 97440 INSURER E : N/A NIA INSURER F : Navigators Insurance Company 42307 COVERAGES CERTIFICATE NUMBER: SEA-003202239-55 REVISION NUMBER: 3 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 ADDLSUER POLICY NUMBER MPOLICY EFF M/DD/YYYY MM LTR /DD//YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 5180113 03/01/2018 03/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE 1XI OCCUR PREMISES Ea occurrence) $ 250,000 X CONTRACTUAL LIAB MED EXP (Any one person) $ 25,000 X PER PROJECT AGG $2M PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 10,000,000 X POLICY ~ JPE 0 [7] LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ I CA 2961543 03/01/2018 03/01/2019 COMBINED SINGLE LIMIT Ea accident $ 3,000,000 A AUTOMOBILE LIABILITY F X ANY AUTO NY18FXR8379531V 03/01/2018 03/01/2019 BODILY INJURY (Per person) $ X OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED LX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PERT EMPLOYERS' LIABILITY Y / N STAUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS WHEN REQUIRED BY WRITTEN AGREEMENT OR CONTRACT AS RESPECTS TO OPERATIONS OF THE NAMED INSURED. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 EAST MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND, OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Raymond M. Schneider ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD