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Home My WebLink AboutInsurance Certificate: Chown Hardware www.saif.com ■ Sal' Work. Life. Oregon. Oregon Workers' Compensation Certificate of Insurance • • Mail to: Certificate holder: XEN 1 INC I CITY OF ASHLAND XEN 1 INC 20 EAST MAIN STREET 7401 SW WASHO CT STE 200 ASHLAND, OR 97520 TUALATIN, OR 97062-8343 The policy of insurance listed below has been issued to the insured named below for the policy period indicated.The insurance afforded by this policy is subject to all the terms,exclusions and conditions of such policy;this policy is subject to change or cancellation at any time. Insured Producer/contact Xen 1 Inc USI Insurance Services Northwest Xen 1 Inc Ryan Cox 7401 SW Washo Ct Ste 200 503.224.8390 ryan.cox@usi.com Tualatin, OR 97062-8343 Issued 12/23/2021 Limits of liability Policy 949996 Bodily Injury by Accident $1,000,000 each accident Period 01/01/2022 to 01/01/2023 Bodily Injury by Disease $1,000,000 each employee Body Injury by Disease $1,000,000 policy limit 'Description of operations/locations/special items For all employees of Chown Hardware, SAIF Policy#950928 Important This certificate is issued as a matter of information only and confers no rights to the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policies above.This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. Authorized representative CAt- Chip Terhune President and CEO 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.584.9812 Policy_OLCA_Certificateoflnsurance www.saif.com • saiF :.. Carrier no: 20001 Endorsement no: WC000313 (Ed. 4308) SAIF policy: 950928 Chown Inc Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: Supply materials and provide services related to commercial doors and hardware. Contractor name: City of Ashland Address: 20 East Main St Ashland Oregon 97520 This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. For each contract subject to this endorsement, the premium charge is one quarter of one percent (.25%) of the manual premium for this policy subject to a maximum of one (1) percent. Effective date: January 01, 2022 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Countersigned January 12, 2022 at Salem, Oregon C/tt- e WC000313 Chip Terhune (Ed. 430B) President and Chief Executive Officer 400 High Street SE Salem,OR 97312 P:800.285.8525 F:503.373.8020 Pol_PC1_E430B C I 01 February 2, 2022 Hello, Included in this packet are the documents required for Insurance.and Worker's Comp for Chown Hardware. If you would prefer to receive these records via email going forward, please send the email address you wish to use to kellyk@chown.com and kellyh@chown.com. If you would prefer to continue receiving the documents via mail, noaction is'required, and the documents will continue to be mailed to you. Thank you for your time and have a great day. Kelly Hudson . 333 NW 16th Ave, Portland,OR 97209 Direct Line: 503-243-6573 https://chowncommercial.com CHOWN HARDWARE Bellevue:+1(800)574-4312 I Portland:+1(800)452-7634 Residential.Chown.com .I Commercial.Chown.com 333 NW 16th Ave.,Portland,OR 97209