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HomeMy WebLinkAboutInsurance Certificate: Phoenix Automotive Center Inc. AC~ ® DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 05/10/2018 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: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 (AC NNO Ext : 888-333-4949 A/c No : 507-446-4664 OWATONNA, MN 55060 E-MAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 339-395-6 INSURER B: PHOENIX AUTOMOTIVE CENTER INC INSURER C: PO BOX 519 PHOENIX, OR 97535-0519 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1 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 INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSR WVD MMIDDIYVYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea oc.'rrence $100,000 X BUSINESS OWNER'S LIABILITY MED EXP (Any one person) A N N 9365712 07/01/2018 07/01/2019 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY El PRO ❑ LOC PRODUCTS - COMPIOP AGG $2,000,000 X PRO- OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) SCHEDULED A OWNED AUTOS ONLY AUTOS N N 9365713 07/01/2018 07/01/2019 BODILY INJURY (Per accident) NON-OWNED PROPERTY DAMAGE HIRED AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000 A EXCESS LIAB CLAIMS-MADE N N 9365716 07/01/2018 07/01/2019 AGGREGATE $2,000,000 DEC) RETENTION WORKERS COMPENSATION PER STATUTE OTH- ER AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT OFFICERIMEMBER 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 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 339-395-6 1 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 BWNDHBS 339-395-6 1 XWXW0021XXXXXXX5# BMDI.05-0217 ITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1814