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HomeMy WebLinkAboutInsurance Certificate: American Industrial Door, LLC 1 AMERIND-03 SPARIANI I DATE (MMIDD/YYYY) '4`CO/?C7 CERTIFICATE OF LIABILITY INSURANCE 07!12/2018 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 NAMEACT Medford Office PHONE PayneWest Insurance, Inc. A/C, Ext) (541) 779-1321 jvc No) (541) 779-9187 ,38 North Central Ave. ADDRESS Medford, OR 97501 - INSURERIS) AFFORDING COVERAGE NAIC M INSURER A: Western National Assurance Company 2144,65 INSURED INSURER a; Western National Mutual Insurance Compaq 15377 American Industrial Door LLC -INSURER C 5022 Table Rock Rd. INSURER D: Central Point, OR 97502 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: 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 ADDLSUBR -POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WV POLICY NUMBER (MMIDDLYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE DAMAGETO RENTED 100,000, CLAIMS-MAOE X occuR CPP105950206 06/23/2018 06!23/2019 A 5 1 000I r~~ _PERSONAL B ADV INJURY 1,000,000 --._GEN'L AGGREGATE LIMIT APPLIES PER -GENERAL AGGREGATE _ , 32,000,000 POLICY ...X.. dE LOC ! PRODUCTS - COMP/OP AGG $ 2,000,0001 OTHER B AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT 1,000,000 _BODILY BODILY INJURY X ANY AUTO CPP105847106 06/23/2018 06/2312019 I BO,Per perscl OWNED SCHEDULED 1 AUTOS ONLY AUTOS BODILY INJURY Per acadent $ - ~ I HIRED NOWSV ED PROPER 'Y DAMAGE AUTOS ONLY AUTOS ONLY _(Per acadentl_._._ S ! B X UMBRELLA LIAR X OCCUR 2,000,000, _EACH OCCURRENCE S _ EXCESS LIAR CLAIMS-MADE UMB100969306 06/23/2018 0612312019 2,000,0001 AGGREGATE- DED X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORiPARTNERIEXECUTIVE _ E.L EACH ACCIDENT $ OFFICERiMEMBER EXCLUDED) NIA in H) - ESL. DISEASE - EA EMPLOYEE' S { If yes descrbe under DESCRIPTION OF OPERATION beloW _ EL DISEASE - POLICY LIMIT $ I DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ! THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main St. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD