HomeMy WebLinkAboutInsurance Certificate: Phoenix Automotive Center Inc ACCPREP CERTIFICATE OF LIABILITY INSURANCE DATE 06/01/2022
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 POUCIES 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
FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER
HOME OFFICE:P.O.BOX 328 PHONECNo,Ext):888-333-4949 FAX
No):507-446-4664
OWATONNA,MN 55060 E-ADMDRESS:CLI ENTCONTACTCENTER((FEDINS.COM
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 339-395-6 INSURER B:FEDERATED RESERVE INSURANCE COMPANY 16024
PHOENIX AUTOMOTIVE CENTER INC INSURER C:
PO BOX 519
PHOENIX,OR 97535-0519 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1 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.
INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP
LTR INSR WVD POLICY NUMBER IMMIDDIYWY) (MMIDDIVYYY) LIMITS
COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100,000
PREMISES IEa occurrence)
X BUSINESS OWNER'S UABIUTY MED EXP(Any one person)
A N N 9365712 07/01/2022 07/01/2023 PERSONAL ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
ZHPOUCY I 1121: I I LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea acdden
X ANY AUTO tl
_ BODILY INJURY(Per person)
B —OWNED AUTOS ONLY _AUTOSULED N N 9365713 07/01/2022 07/01/2023 BODILY INJURY(Per accident)
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY (Per accident)
• X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $2,000,000
A EXCESS LIAB CLAIMS-MADE N N 9365716 07/01/2022 07/01/2023 AGGREGATE $2,000,000
DED RETENTION
WORKERS COMPENSATION OTH-
AND EMPLOYERS'LIABILITY YN PER STATUTE ER
/
ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory In NH) E.L.DISEASE•EA EMPLOYEE
IT yes,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required)
CERTIFICATE HOLDER CANCELLATION
339-395-6 1 0
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELJVERED IN
ASHLAND,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE 1G
6 /
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