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HomeMy WebLinkAboutInsurance Certificate: HazmatlQ by Federal Resources Client#:1545117 FRSHOL1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/15/2020 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Jennifer Beasley USI Insurance Services,LLC PHONE FAX (PalExt>:984-255-1083 (A/C,No):877-506-0509 8540 Colonnade Center Dr. A DAILs: jennifer.beasley@usi.com Suite 111 INSURER(S)AFFORDING COVERAGE NAIL# Raleigh,NC 27615 INSURER A:Hartford Fire Insurance Company 19682 INSURED INSURER B:Twin City Fire Insurance Company 29459 HazmatlQ by Federal Resources INSURER C:Trumbull Insurance Company 27120 235G Log Canoe Circle INSURER D: Stevensville,MD 21666-2165 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 22UENBI9538 10/01/2020 12/01/2021 EACHOCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISES(Eaoceu ante) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECOT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ c AUTOMOBILE LIABILITY 22UENBH6529 12/16/2020 12/01/2021 Ea IlEcI l l tSINGLE LIMIT 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILYINJURYPeraccident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) UMBRELLA UAB • OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 22WBAC3OCU 12/16/2020 12/01/2021 X PER OTH- AND EMPLOYERS'LIABILITY y/N STATUTE FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) The City of Ashland,Oregon is included as additional insured for General Liability,Automobile Liability, and Professional Liability as their interest may appear as required by written contract.General Liability, Automobile Liability,and Professional Liability coverage is primary and non-contributory. CERTIFICATE HOLDER CANCELLATION The City of Ashford,Oregon SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520-0000 AUTHORIZED REPRESENTATIVE Q ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S30640216/M30638348 SK2Zp This page has been left blank intentionally. USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING PO BOX 629035 EL DORADO HILLS CA 95762-9035 THE CITY OF ASHFORD OREGON 20 E MAIN ST ASHLAND OR 97520-1814