HomeMy WebLinkAboutInsurance Certificate: Ashland Medford Plumbing Inc (2) ACCPR CO DATE IMM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 02/062019
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 POUCIES 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
s and conditions of the policy, certain policies may require an endorsement. A statement on this
SUBROGATION IS WAIVED, subject to the terms p y, p Y 9
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PHONE
HOME OFFICE: P.O. BOX 328 (A/C,No,Ext):888-333-4949 FAX No):507-446-4664
OWATONNA, MN 55060 ADDRESS:CLIENTCONTACTCENTER aFEDINS.COM
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024
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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD IMMIDDIYYYY) (MMIDDIYYYY)
X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED $100,000
I CLAIMS-MADE X OCCUR PREMISES(Ea occurrence)
MED EXP(Any one person) EXCLUDED
A N N 9337481 03/20/2019 03/20/2020 PERSONAL A.ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
H X POLICY PRO-
JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
X ANY AUTO BODILY INJURY(Per person)
OWNED AUTOS ONLY SCHEDULED
A AUTOS N N 9337481 03/20/2019 03/20/2020 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 03/20/2019 03/20/2020 AGGREGATE $2,000,000
DED RETENTION
WORKERS COMPENSATION PER STATUTE OTH-
ER
AND EMPLOYERS'LIABILITY y/N
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 E.L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required)
CERTIFICATE HOLDER CANCELLATION
358-611-2 124 0
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POUCIES 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
144.414...,/ 6 ge„, .,
O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
rBWNDHBS 358-611-2124
XWXW0021 XXXXXXX5## B7000-08-0056
CITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520-1814