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HomeMy WebLinkAboutInsurance Certificate-Star Collision Centers Inc. DBA Star Body Works DATE (MM/DD/YYYY) A~RD® CERTIFICATE OF LIABILITY INSURANCE 5,2,2018 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 endorsement(s). PRODUCER CONTACT NAME: YouZoom Insurance Services, Inc PHONE FAX 6900 College Blvd A/c No. EXtI: 888-240-8803 (A/c, No): 877-835-1833 E-MAIL Ste 1000 ADDRESS: AMServiceCenter o@arrowhead rp.com Overland Park KS 66211 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American Guarantee and Liability Insurance 26247 INSURED STARCOL-01 INSURER B : Zurich American Insurance Company 16535 Star Collision Centers Inc, DBA Star Body Works, DBA Star 24Hour Towing INSURER C : Great American Alliance Insurance Company 26832 PO Box 8300 INSURER D : Medford OR 97501 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1781871544 REVISION NUMBER: 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 ADDL SUBR I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I D WVD POLICY NUMBER MM/DD/YYYY MWDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y CP01638679-02 511/2018 5/1/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE FKOCCUR DAMAGES ( RENTED PREMISES E. occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY I. J [ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY CP01638679-02 5/1/2018 5/1/2019 COMBINED SINGLE LIMIT $ 1,000,000 _ Ea accident ANY AUTO BODILY INJURY (Per person) $ X OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY LX AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C X UMBRELLA LIAB X OCCUR UME187316-00 5/1/2018 5/1/2019 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 DED X RETENTION $ Prod/Comp Op Ag $ 4,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANYPROPRIETOR/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 $ B Garage Keepers CP01638679-02 5/1/2018 5/1/2019 Limit See Descrip of Ops Motor Truck Cargo Limit/Deductible $200,00041000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured Continued: Star Collision Center of Ashland Inc dba Star Body Works- Ashland Star collision Center of Rogue River dba Star Body Works- Rogue River Star Collision Center of Grants Pass LLC dba Star Body Works-Grants Pass Garage Keepers Limit (Per location) Loc 01: 609 West McAndrews Rd., Medford, OR 97501 - Limit $200,000 Loc 03: 930 Summit Ave., Medford, OR 97501 - Limit $500,000 See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF ASHLAND 20 EAST MAIN STREET AUTHORIZED REPRESENTATIVE ASHLAND OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD