HomeMy WebLinkAboutInsurance Certificate: Jahnke Heating & Air Conditioning Inc.
'`'4CC)R CERTIFICATE OF LIABILITY INSURANCE 02/20/ DAT 2018 JMMfDD/YYYYJ
02P20/
018
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 endorsements .
PRODUCER CONTACT
NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328 a/cNrEio Ext : 888-333-4949 n/c No : 507-4464664
OWATONNA, MN 55060 E-MAIL
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 366-839-9 INSURER B:
JAHNKE HEATING & AIR CONDITIONING INC INSURER C:
PO BOX 660
TALENT, OR 97540-0660 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 72 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 DL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MMIDDIYYYY MMIDDIYYYY
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR PREMISES Ea o,.,ronce$100,000
FxI
MED EXP (Any one person) EXCLUDED
A Y N 9089608 04/08/2018 04/08/2019 PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X POLICY ❑ JEC ❑ LOC PRODUCTS - COMPIOP AGG $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
Ea accident)
X ANY AUTO BODILY INJURY (Per person)
OWNED AUTOS ONLY SCHEDULED
A AUTOS N N 9089608 04/08/2018 04/08/2019 BODILY INJURY (Per accidenq
HIRED AUTOS ONLY NON-OWNED
"
AUTOS ONLY PROPERTY DAMAGE
(,.c ciden
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000
A EXCESS LIAB CLAIMS-MADE N N 9089609 04/08/2018 04/08/2019 AGGREGATE $1,000,000
DED RETENTION
WORKERS COMPENSATION PER STATUTE OER
TH-
R
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETORIPARTNERIEXECUTIVE ❑ E.L. EACH ACCIDENT
OFFICEWMEMBER EXCLUDED? N I A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE
If yes, describe under E.L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS below
I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) !
THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES
OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY.
CERTIFICATE HOLDER CANCELLATION
366-839-9 72 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
4"
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
BWNDHBS 366-839-9 72
XWXW0021 XXXXXXX5## BL001-05 - 0139
CITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520-1814