HomeMy WebLinkAboutInsurance Certificate: Phoenix Auto Center TE(1141)AiDD/YYYY)
'4t✓°® CERTIFICATE OF LIABILITY INSURANCE � 05/21/2020
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 I
FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER
PHONE FAX
HOME OFFICE:P.O.BOX 328 (A/C, Ito
c.No,Ext):888-333-4949 A ,No):507-446-4684
OWATONNA,MN 55060 E-MAILDSS:CLI ENTCONTACTCENTEReFEDINS.COM
I INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED 339-395.6 INSURER B:
PHOENIX AUTOMOTIVE CENTER INC INSURER C:
PO BOX 519
PHOENIX,OR 97535-0519 INSURER D:
INSURER E: I
INSURER F: I
COVERAGES CERTIFICATE NUMBER:1 1 REVISION NUMBER:0
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUER 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 POUCY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVDIMMIDDIYYVY). IMMIDDIYYYYI
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
CLAIMS-MADE n OCCUR PREMISES Ea occurrence) $100,000
X BUSINESS OWNER'S LIABILITY
MED EXP(Any one Person)
A N N 9365712 07/01/2020 07/01/2021 PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY JECT LOC PRODUCTS-COMP/OP AGO $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 N N 9365713 07/01/2020 07/01/2021 BODILY INJURY(Per accident
—
HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE
AUTOS ONLY (Per accident
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $2,000,000
^—
A EXCESS LIAR CLAIMS-MADE N N 9365716 07/01/2020 07/01/2021 AGGREGATE $2,000,000
DED I RETENTION i
WORKERS COMPENSATION PER STATUTE OTH•
AND EMPLOYERS'LIABILITY Y/N ER
ANY PROPRIETORIPARTNERIEXECUTIVE _ E.L.EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? 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 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
• 339-395-6 1 0
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 E MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ASHLAND,OR 97520-1814 ACCORDANCEi WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE _ (/` JIG
I 41444)1,14d
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