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Home My WebLink AboutInsurance Certificate: Welburn ElectricACCORe CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDYVYY) 12/1712019 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 Protectors Insurance, LLC P.O. Box 4669 Medford OR 97504 NAME: CONTACT Terry Friend PHONE . 541-842-2958 aC No:641-772-1906 EMAIL ADDRESS: terryf@pmtectorsins.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: The Cincinnati Insurance CO 10677 INSURED WELBU-1 INSURER B: SAIF Corporation 524113 Welbum Electric Inc PO Box 329 INSURER O: Phoenix OR 97535 INSURERD: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 645396142 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 LTRitimIlm TYPE OF INSURANCE ADOL SUBR POLICYNUMBER MMIDDYNYYYI EFF MM/DLIC� LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y EPP 0295267 12/23/2017 12/23/2020 EACH OCCURRENCE $1,DDa,000 PREMISES Es occurrence $1,000.000 MED EXP (Any one person) $15,000 PERSONAL S ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY E JEC M LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY 1X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y EBA 0295267 12/23/2019 12/23/2020 COMBINED SINGLE LIMIT Ea accident $1.000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per acclden0 $ PROPERTYDAMAGE Per ardtlent $ A X UMBRELLALIA13 EXCESS LIAB X OCCUR CLAIMS -MADE EPP 0295267 12/23/2019 12123/2020 EACH OCCURRENCE $5,000,000 AGGREGATE $5.000,000 DED RETENTION$ $ B — WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNEWEXECUTIVE YIN OFFICER/MEMBEREXCLUDEDI (Mandatory In NH) — It yes, describe under DE SCRIPTION OF OPERATIONS below 488390 - —_--- — 10/1/2019 10/1/2020 X I 'TA ST TUTE X ETH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE- EA EMPLOYEE '$1,000,000 E.L DISEASE -POLICY LIMIT $1,000,000 A Professional Pollution EPP 0295267 12/23/2019 12/23/2020 1000000 1000000 6000 deductible 3000 deductible DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) As additional insured per policy endorsement GA233. CFRTIFICATE i4ni nER 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 E Main St Ashland OR 97520 AUTHORMED REPRESENTATIVE 4�1 Ant 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD CoYerage Summary CGL-Contractors' Broadened Endorsement Contractors"Commercial General Liability Broadened.Endorsem'ent 6A238i Liability Coverages Limits Employee beneft liability ($1,'000 deductible) $1,000,000 each employee! ,,go aggregate Expands damage to premises rented to Insured to include lightning; At the lesser of $500,000 or the smoke, soot or4water CGL'each occurrence limit \Miverof subirogatlon if required it awritten,eontract Included Unintentional failure to disclose existing hazards provision Included Broadened noticetof occurrence Included Property damage to borrowed egdipment when not in; use ($250tdeductible) $10;000'e`ach occurrence Newly formed or neW]y'acquired organizations forup to 180 dayst ,Included Automatic additional insured coverage where, required in a written, contractor oral agreement ;(where .acertificate of ins- ranceIshowing that person_or organization as anaddltlonal insured has been issued) Included for lessor`s ment of premises, lessors of equip, vendors,'state,br,. political subtlivision'5 permits relating to, premises, state or political subdivision`_s' permits relating to contractor operations ;Autornatic atlditlonal insured coverage -where required in a written: =contractor oral agreement (Where a certificate of insurance showing4hai pe'rson,or organization�as;an additionalinsured has been issued) from Included the named insured's work perform6ed'for thatperson or;organizatiom Varying'degrees of coverage apply based upon the additional' insured ;requirements included in written and oral contracts (ezceptA27 Supplementary payments s Bail bonds .$1,000 Loss of'earnings $350 per -day Employees.as insureds for>specified hedlt_hcare;services (nurses', EMTs Included :and paramedics) Medical payments $T0000 any bne,person Voluntary property damage ($250 deductible),, $1;000 each occurrence 'Care, custody orcontfol ($250 deductible), $5;000 each occurrence Broadened "contractual liability for work within 50 feet of railroad property Included ,Cbpytlght9,2012 The;Clncinna0 ln5uraM0 Company All dghls reserved. Do not post.Silllne, inwlfoleorKpatl; -?�.; withoat written pennisslon: - A A*. 694 (7/1,2) Ed.2 "L °F' CINCINNATI INSURANCE COMPANIES