HomeMy WebLinkAboutInsurance Certificate: Cascade Communication Services Inc (2) ACERTIFICATE OF LIABILITY INSURANCE DATE12/21/2R1RD/YY1Y)
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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 ah 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 •
P• HONE CLIENT CONTACT CENTER
HOME OFFICE:P.O.BOX 328 • . . (A/C,No,Eel):888-333-4949 FAX No):507-446-4664
OWATONNA,MN 55060 E-MAIL
ADDRESS:CLIENTCONTACTCENTERi 1FEDINS.COM
INSURER(S)AFFORDING COVERAGE MAIC N
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 348-697-4 INSURER B:FEDERATED RESERVE INSURANCE COMPANY 16024
CASCADE.COMMUNICATION SERVICES INC INSURER C:
•
2961 HELMS RD' '
-- GRANTS PASS.,OR.97527-9515INSURER D:
INSURER E:
•
•
• INSURER F:
COVERAGES CERTIFICATE NUMBER:55 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 TYRE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD IMMIDDIYYYY) (MMIDDIYYYY)
• COMMERCIAL GENERAL UABIUTY • • ' . ' EACH OCCURRENCE • $1,000,000 '
• CLAIMS-MADE n OCCUR PREMISES Ea occruE enro) $100,000
MED EXP(Any one person)
X. BUSINESS OWNER'S LIABILITY ,
A N N 9062279 02/01/2023 02/01/2024 PERSONAL&ADV INJURY $1,000,000
•
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
XPOUCY I 1721: LOC . • PRODUCTS-COMP/OP AGG - $2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
(Ea ecddenl)
X ANY AUTO . ' BODILY INJURY(Per person)
OWNED AUTOS ONLY SCHEDULED
B _ _AUTOS N N 9062280 02/01/2023 02/01/2024 BODILY INJURY(Per accident)
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS ONLY
AUTOS ONLY
(Per accident)
•
X UMBRELLA LIAB X OCCUR • EACH OCCURRENCE $1,000,000
A EXCESS LIAB CLAIMS-MADE N N . 9062569 02/01/2023 02/01/2024 AGGREGATE . . $1,000,000
DED I RETENTION
WORKERS COMPENSATION IPER STATUTE' I OER
• • 'AND EMPLOYERS'LIABILITY• • • y/N '
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT
• OFFICER/MEMBER EXCLUDED? NIA
(Mandatory In NH), E.L DISEASE-EA EMPLOYEE
It yes,describe under • ' ' -
.••••DESCRIPTION OPERATIONS below E.L DISEASE-POLICY LIMIT
- -DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101;Additional Remarks Schedule,may be attached It more space is required)
. • .
•
CERTIFICATE HOLDER . . CANCELLATION
348-697-4 . . 55 0
CITY OF ASHLAND INFORMATION SYSTEMS - SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE-CANCELLED BEFORE
• -- 90 N MOUNTAIN AVE . . . . . . ... THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND,OR 97520-2014 ACCORDANCE WITH THE POUCY PROVISIONS.
• • AUTHORIZED REPRESENTATIVE 1G
6 r e, ,
- • O 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016(03) . • The ACORD name and logo are registered marks of ACORD
348-697-4 55
#BWN DH BS BM000-06-0067
#XWXW0021 XXXXXXX5#
CITY OF ASHLAND INFORMATION SYSTEMS
90 N Mountain Ave
Ashland, OR 97520-2014