HomeMy WebLinkAboutInsurance Certificate: Kaylor Electric LLC ACC'7R`rl1 DATE(MM/ODmYV)
L1RD CERTIFICATE OF LIABILITY INSURANCE 05/18/2023
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,EXTENDOR 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 NAME GT CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PHONE FAX
HOME OFFICE:P.O.BOX 328 (A/C,No,Eat):888-333-4949 (A/C,No):507-446.4664
OWATONNA,MN 55060 ADDRESS:CLI ENTCONTACTCENTERnFEDINS.COM
INSURERS AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 343-086-5 INSURER B:
KAYLOR ELECTRIC LLC INSURER C:
PO BOX 639
PHOENIX,OR 97535-0639 INSURER D:
INSURER E:
INSURER F: _
COVERAGES CERTIFICATE NUMBER:13 REVISION NUMBER: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 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,
ITR TYPE OF INSURANCE p Sap POLICY NUMBER (MMNS(YYYYI (MMliDryYYYI LIMITS
COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $1,000,000
CLAIMS-MADE 1-1OCCURpAMAGErenTO nRENTED PREMISES $100,000
EaJ?car
X BUSINESS OWNER'S LIABILITY MED EXP(Any one person)
A N N 9118896 07/01/2023 07/01/2024 PERSONAL&ADV INJURY $1,000,000
GEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
V
POLICY Dm E LOC PRODUCTS&COMP/OP AGO $2,000,000
OTHER:
AUTOMOBILE LIABILITY 'EOMB tISINOLE UMIT _ $1,000,000
X ANY AUTO _ BODILY INJURY(Per Person)
A _OWNED AUTOS ONLY' 'AuCjEDULED N N 9118897 07/01/2023 07/01/2024 BODILY INJURY(Per Accident)
HIRED AUTOS ONLY NON-OWNED PROPERTYDAMAGE
AUTOS ONLY leer Acciden0
UMBRELLA LIAB _OCCUR EACH OCCURRENCE
EXCESS LIAR CLAIMS-MADE AGGREGATE
DED RETENTION
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN C PER STATUTE OTHER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory In NH) E.L DISEASE f EMPLOYEE
If yes,describe under '- -
DESCRIPTION OF OPERATIONS below EL DISEASE•POLICY LIMIT
•
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATEHOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE
CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
FOR BUSINESSONNERS LIABILITY.
•
CERTIFICATE HOLDER CANCELLATION
3-086-5 13 0
OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
CITY
20 E MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ASHLAND,OR 97520-1814
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE Aj `
O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD