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HomeMy WebLinkAboutInsurance Certificate: Key Manufacturing & Rentals, Inc �■,,N KEYMANU-01 BRANDI '4c<i)R if, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4......---- 2/27/2019 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: Hagan Hamilton Insurance PHONE FAX PO Box 847 (NC,No,Ext):(503)538-4455 (A/C,No): Mcminnville,OR 97128 E-MAIL DSS: INSURERS)AFFORDING COVERAGE NAIC# INSURER A:EMC Insurance Companies 25186 INSURED INSURER B:SAIF 36196 Key Manufacturing&Rentals,Inc. INSURERC: 20850 SW 115th Ave.#190 INSURERD: Tualatin,OR 97062 - INSURER E: i 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X 5X79810 4/1/2019 4/1/2020 PREMSES EaEoccu ence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 12481" LOC PRODUCTS-COMP/OP AGG I $ 2,000,000 OTHER: EPLI i$ 100,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 5X79810 4/1/2019 4/1/2020 BODILY INJURY(Per person) $ OWNED — SCHEDULED AURTEO�S ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLYY (PerraEcciidentDAMAGE $ $ A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE 5X79810 4/1/2019 4/1/2020 AGGREGATE $ DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION _ PER ER AND EMPLOYERS'LIABILITY 854251 9/1/2018 9/1/2019 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 500,000 ' If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Ashland,Oregon and its elected officials,officers and employee are additional insured with primary and non-contributory coverage including a Waiver of Subrogation per forms CG7578. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St Ashland,OR 97520 AUTHORIZED REPRESENTATIVE 0—,-----( i ' (2` ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD