HomeMy WebLinkAboutInsurance Certificate: Ashland Medford Plumbing Inc. (2)
A~~ ® DATE(MM/DD/WYY)
L~ CERTIFICATE OF LIABILITY INSURANCE 04/302018
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 NAWCr CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY
PHONE HOME OFFICE: P.O. BOX 328 A CNO EXt : 888-333-4949 A/c No): 507-446-4664
OWATONNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
INSURER(S) AFFORDING COVERAGE NAIC If
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: 1
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 BUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MMIDDIYYYV MMIDDIYYYY
X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $1,000,000 D RE
CLAIMS-MADE OCCUR PRMISES Ea oNwErence $100,000
MED EXP (Any one person) EXCLUDED
A N N 9337481 03/20/2018 03/20/2019 PERSONAL& ADV INJURY $1,000,000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY ❑PRO JECT -
X ❑LOC PRODUCTS - COMP/OP AGO $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accitlen $1,000,000
X ANY AUTO BODILY INJURY (Per person)
A OWNED AUTOS ONLY AUTOSULED N N 9337481 03120/2018 03/20/2019 BODILY INJURY (Per accident)
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS ONLY AUTOS ONLY Per accitlen
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $2,000,000
A ESS LIAB CLAIMS-MADE N N 9337482 03/20/2018 03/20/2019 AGGREGATE $2,000,000
DM RETENTION
WORKERS COMPENSATION PERSTATUTE ER
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT
_ OFFICEWMEMBER EXCLUDED? N I A
ryinNH)_ E.1- DISEASE - EA EMPLOYEE
(MantlatoII yes, describe under E.L DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Sencoule, may be anarhed If more space is required)
CERTIFICATE HOLDER CANCELLATION
358-611-2 1241
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 G
O 1988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD