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HomeMy WebLinkAboutInsurance Certificate: Key Maufacturing & Rentals Inc . -„-- --.- . . . II • •_ • • :.,--.•••••••77.11 . ' • . • KEYMANU-CL - . • LASHAWNA ACCORGE EimmiDEvywy) CERTIFICATE OF LIABILITY INSURANCE oAT• - •- • „ . . . . . . • • 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•Pollcy(les)must have ADDITIONAL INSURED provisions or be enClorSed. • 'If•SUBROGATION IS WAIVED; subject to the terms and conditions of the.policy;certain Policies may require an endorsement A statement on MIS certifiCate does not confer rights to the cettificate holder.in IleU of Such endorsenient(S). . 1 . • . ,:. 1 . . I , .. • : : . . . • :. PRODUCER • .' • ' Wel.:Brandi Bowers,. . • . . . 2:. : :° .:- • ••:: ' . . Hagan Hamilton InsurancePHONE FAX (AIC,,No,Ext):- -(503)5653326 , :. • ' . • I WC,No)(503)843 3394 .: McMinnville,OR 97128 Mass;Brancli@haganhaMilton.con,. ;. : ::. .. : •• :.. . i :.. - - • : . -- INSURER(S)AFFORDING COVERAGE:• . •- ..• • .•NAIC#• • . . . . . - • - •• • • .• . • . • • .• . ..• . • .- • . • • • . •INSURER A:ENIC.IniuranCe COmpanies . • • .. • • . :• r 25186. , . • INSURED • • INSURER B:SAIF • : • :.• • : :.• : • : • : .• . ; 36196 • . . • -• — . • . . . . . . . . . . • Key Manufacturing&Rentals;Int. INSURER C • . 20850 SW 115th Ave.#190 " .INSURERD . . . . . . . . . Tualatin,.OR 97062 • 0 • • • " . . 0 'COVERAGES ° :- •° - : - :CERTIFICATE NUMBER:: • .• : : . ° • • : : :: '. : - • REVISION'NUMBER: : ' : 0 : 00 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 REQOREMENT,.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN; THEINSURANCE 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 -• ' • • • ' • - • • •ADDL SUBR •• • POLICY. ,.... ,, . • POLICY EFF• POLICY EXP• ' - • • . •' - .; • . " • LTR •-- . :TYPE OF INSURANCE' : . - INSD WVD : . • NUMBER . .. . (niuroyyyy) immirmireyyi . •' . LIMITS. . • :, • A :x: COMMERCIAL GENERAL LIABILITY' • '. • ' • ' ' ' -\ ' . EACH OCCURRENCE . ..:_i . • . . .:1,000,000 . • CLAIMS-MADE X OCCUR • k 5X7981.0 4/1/2022 ° 4/1/2023 PEasii?E'rroZI;ce. ). :$:-:: .. . - - 5.00,000 • - - , • . MED EXP(Any one person) 1$ ' - 0 000 • ;.- - - • - •• PERoONAL&ADV INJURY• __$ • • ':.1,000,000 • ' - ' .:' ' ' • ' • .-: w-- • . ' 2 000 Og° GENERAL AuGREGA 1 o•• • S :0 : ' ' •• ' • GEN:L AGGREGATE LIMIT APPLIES PER: '- •. X poLiby 7 spa,. - . LOC . . . -. - • • 1 • • PRODUCTS AGO _$ '• --• 2,000,000 OThER EPLI • • ." . -$ 1 000 otid • :- •-- COMBINED IE IT • - 'A AUTOMOBILE LIABILITY • : • .0 0• 0 0 : • - (Ea accident)SNGLLIM •• • ' -$. -' - 1000000- ' •• ' X ANYAUTO • . . X wool() 4/1/2022 4/1/2023 :BODILY:INJUirt1'.(Peeperoh) $ : - .• • O OWNED•_. SCHEDULED - • :•AUTOS ONLY • ' 'AUTOS'• . - 0 BODILY INJURY:(Per accident) 1 ' • : •. • ' • . • HIRED • - • 0 °, . .40N-OWNED . • • PI?iallir!7A9E. :: : : : • : • . ::AUTOS•ONLY _ AUTOS ONLY tat $ _ • .. . .. '• .. • . . . • .. . . . .• .• • ' . • . . . . . • .• A X UMBRELLA LIAB :•_ EACH OCCUR ' . - - . . . . 4 000 000•. ' • • '. ' 'OCCURRENCE • '' $ • : ' • ' EXCESS LIAB:. . CLAIMSMADE5X79810 4/1/2022 . 4/1/2023 ." •• • ' •• .' • • 4 000 006 • . • AGGREGATE. • ° • ' •$ :' • ' •• ' • DED X RETENTION$ . • .10,000 : .. . •. ; . . . •:. . . . • ,:. .. ... . . , •. - : • • .. . : •:: i ::. 4,900,000 - B WORKERS COMPENSATION• • . ' : • ' • • . • ' • ' • ' • • ' PER 0TH AND EMPLOYERS'LIABILITY ' '' - • ' • STATUTE •' ER ' ••" • • m° e . . 'YIN .• • . 854251 • . • • • ANY PROPRIETOR/PARTNER/EXECUTIVE n 9/1/2021 • : 9/1/2022 .:..:: ACCIDENTf EL:om..;t1 : 1 .' : :. . '. • . 1,000,000 oFFicEpimEmmt ExcwDED? . . . NIA . . . (Mandatory In NH) . . , . . ' . 1 000 000 • , _ _ _ _. — _-. _ ., --- • -- 'El.DISEASE.-EA EMPLOYEE.$ - -.-• --".• •' If yes,deseribelinder ' . . ' . 1 000 0.00 - . DESCRIPTION OF OPERATIONS below . ••" • • . • • • •' . • . •• . • . • • .• •- .. E.L.DISEASE-POLICY LIMIT. $ ' '. • ?. • ' . . • , . . • . . . . . . • • • . . ..• . . . .. . . . . . • ... . . ' .. . . • • • • • • • • • .. . . . . . . . . . . . . . . . . . . . . • . . • .• .• • . . . . • . • . DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Acklitiorial Remarks Schedule;may be attached If more,space is required) . Clty.Of Ashland is listed as additional insured per policy provisions- - • • . . '- . • - • - . . - - ' - • - - - ' - - . . . . •CERTIFICATE HOLDER .: • - * • • - .: : .. - 2 • • • .. i CANCELLATION: - • ' :• .. : ' . . . . , .. .. . 0 • SHOULD ANY OF THE ABOVE-DESCRIBED POLICIES BE CANCELLED BEFORE . • THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN • City Ashland - ACCORDANCE WITH THE POLICY PROVISIONS. " • • ' 20 E Main . . . . Ashland,OR 97520 . .. . . .. . . . • . .• . .• . . . . . . . . . . . . ,AUTHORIZED REPRESENTATIVE . • . • - .." - .e.ii4r4;...- . . . . , . . . . ... . . . . . .. . 'ACORD 25(2016/03) • '• ©1988015ACORD CORPORATION. All rights•reServed ' . . The ACORD name and logo are registered marks of ACORD