HomeMy WebLinkAboutInsurance Certificate: American Industrial Door LLC ACERTIFICATE OF LIABILITY INSURANCE DATE06/13/2022
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 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 CONTACT
FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER
PHONE HOME OFFICE:P.O.BOX 328 (A/C,No,Ext):888-333-4949 FAX No):507-446-4664
OWATONNA,MN 55060 E-MAIL CLIENTCONTACTCENTER(aTFEDINS.COM
_ INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 391-637-6 INSURER B:
AMERICAN INDUSTRIAL DOOR,LLC INSURER C:
6142 CRATER LAKE AVE
CENTRAL POINT,OR 97502-9414INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:28 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.
IXP
LTR TYPE OF INSURANCE IR NSR SUERwPOLICY NUMBER IMM DDIIYY YYY) (MFF M/DDIYYYYI LIMITS
X COMMERCIAL GENERAL�LIABIUTY EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED -
CLAS-MADE I rI OCCUR PREMISES Ea occurrence) $100,000
IM
MED EXP(Anyone person) EXCLUDED
A N N 9841842 07/06/2022 07/06/2023 PERSONAL&ADV INJURY $1,000,000
GE 'I-AAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
O-
X POLICY IJEPRCT LOC PRODUCTS-COMPIOP AGG $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
X ANY AUTO - BODILY INJURY(Per person)
OWNED AUTOS ONLY SCHEDULED
A AUTOS
_AN N 9841842 07/06/2022 07/05/2023 BODILY INJURY(Per accident)
HIRED AUTOS ONLY NON OWNED PROPERTY DAMAGE
AUTOS ONLY (Per accident)
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000
`
A EXCESS LIAB CLAIMS-MADE N N 9841843 07/06/2022 07/06/2023 AGGREGATE $5,000,000
DEO RETENTION
WORKERS COMPENSATION 0TH-
AND EMPLOYERS'LIABILITY !N PER STATUTE ER
ANY PROPRIETORIPARTNERIEXECUTIVEI El.EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? I N I A
(Mandatory In NH) E.L DISEASE-EA EMPLOYEE
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 1a1,Additional Remarks Sdudule,may be attached If more space Is required)
r i ., , - • ._ _. .. .. _ . _ .. ._ _..-.. .._ —..I _..
CERTIFICATE HOLDER ' - CANCELLATION ,
391-637-6 28 0
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ELECTED OFFICIALS OFC&EMPL THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 E MAIN ST ACCORDANCE WITH THE POLICY PROVISIONS.
ASHLAND,OR 97520-1814
AUTHORIZED REPRESENTATIVE Yeiv.
• O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2010!03) The ACORD name and logo are registered marks of ACORD
391-637-6 28
#BWNDHBS BE000-09-0163
#XWXW0021 XXXXX)O(5#
CITY OF ASHLAND
ELECTED OFFICIALS OFC& EMPL
20 E Main St
Ashland, OR 97520-1814