HomeMy WebLinkAboutInsurance Certificate: Ashland Medford Plumbing Inc
FEDEMTED
INSURANCEqF®
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, - - -
I
Client Contact Center
Federated Insurance Companies
Enclosed:
Certificate of Insurance
MISC-0974 (04-13)
ACORO® DATE (MMMD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 01/29!2018
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: M CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328 (AC NNo Ext : 888-333 4949 a/c No : 507 446664
OWATONNA, MN 55060 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 97501-0894 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 TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MM/DD/YYYY MM/DD/YYYY
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
E To CLAIMS-MADE FKOCCUR PMISES Ea occuErence $100,000
MED EXP (Any one person) EXCLUDED
A N N 9337481 03/20/2018 03/20/2019 PERSONAL & ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY ❑ PRO- ❑ LOC PRODUCTS - COMP/OP AGG $2,000,000
NOTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea acciden $1,000,000
X ANY AUTO BODILY INJURY (Per person)
SCHEDULED
A OWNED AUTOS ONLY AUTOS N N 9337481 03/20/2018 03/20/2019 BODILY INJURY (Per accident)
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY Per accident)
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000
A EXCESS LIAB CLAIMS-MADE N N 9337482 03/20/2018 03/20/2019 AGGREGATE $2,000,000
DED RETENTION
WORKERS COMPENSATION - PER STATUTE OTH-
AND EMPLOYERS' LIABILITY ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? N I 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 I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
BWNDHBS 358-611-2124
XWXWO021 XXXXXXX5## BU001-06 - 0239
ITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520-1814