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HomeMy WebLinkAboutInsurance Certificate: American Industrial Door (2) --------.." AMERIND-03 . " . APITTMAN 1E9RO' CERTIFICATE OF LIABILITY INSURANCE DAT/17/2DNYYY) ��� sn7/zols 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: Medford Office PHONE No,Est):(541)779-1321 FAX PayneWest Insurance,Inc. ( )�( ) . (NC,No):(541)779-9187 38 North Central Ave. ADDRESS: Medford,OR 97501 INSURER(S)AFFORDING COVERAGE NAIC# ' INSURER A:Western National Assurance Company 24465 INSURED INSURER a:Western National Mutual Insurance Co 15377 American Industrial Door LLC INSURER C: 5022 Table Rock Rd. INSURER D: Central Point,OR 97502 INSURER E: 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 POUCYEFF POUCYEXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMM/DD/YYYYI (MMIDDNYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CPP105950207 6/23/2019 6/23/2020 MAGEEOEwED e ncel $ 100,000 • MED EXP(Any one person) $ 5,000 1,000,000 • PERSONAL BADV INJURY $ ' GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JE 9f LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Prop.Damage Ded $ 1,000 B AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ _ X ANY AUTO CPP105847107 6/23/2019 6/2312020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY _ AST AUTOS PRO acccdentDAMAGE $ $ B X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESSLIAB CLAIMS-MADE UMB100969307 6/23/2019 6/23/2020 AGGREGATE $ 2,000,000 DED X RETENTIONS 10,000 $ WORKERS COMPENSATION STATUTE 0TH AND EMPLOYERS'LIABILITY YIN OFFICERR/MREMBEER EXCLUDEDX ECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.TE WILL BE DEL • DELIVERED IN 20 E.Main St. Ashland,OR 97520 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. ' The ACORD name and logo are registered marks of ACORD