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HomeMy WebLinkAboutInsurance Certificate: Mawje,Inc. dba Ashland Tow & Texaco AC RO® ; ,:.i( RTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `. 08/13/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOV 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(les) must 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 541=8.95-4515 541-741-9175 CONTACTNAME: Ryan Hoffstot Hoffstot Insurance Agency Inc, PHONE (A/C.No.Exf): 541-895-4515 iuc,No): 541-741-9175 PO Box 219 .. aooliess: rhoffstot1@farmersagent.com Creswell, OR 97426 • INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Truck Insurance Exchange 21709 INSURED INSURER B: Mawje Inc. INSURER C: • DBA Ashland Towing and Texaco INSURER D: PO Box 715 INSURERE: Ashland, OR 97520 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 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 ADDL SUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)_ LIMITS ✓ COMMERCIAL GENERAL`LIABILITY ✓ EACH OCCURRENCE $ 1,000,000 A DAMAGE TO RENTED CLAIMS-MADE ✓ OCCUR. PREMISES Ea occurrence) $ 1 00,000 604672648 08/19/2019 08/19/2020 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ . AUTOMOBILE LIABILITY ✓• (Ea a IN SINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ✓ ALL OWNED SCHEDULED )604672646 08/19/2019 08/19/2020 BODILY INJURY(Per accident $ AUTOS AUTOS _ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) ✓ Garage $$4,000,000 ✓ UMBRELLA LIAR •✓ OCCUR ii EACH OCCURRENCE _ $ 1,000,000 A EXCESS LIAB CLAIMS-MADE 604672650 AGGREGATE $ 1,000,000 DED RETENTION$ 08/19/2019 08/19/2020 $ WORKERS COMPENSATION PER OTH- ' AND EMPLOYERS'LIABILITY Y/N • STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) . E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Garagekeeper/On Hook ✓ 604672648 08/19/2019 08/19/2020 $80,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) 2925 Highway 66, Ashland, OR 97520 There is a 30 days notice of cancellation on all policies to the certificate Holder . CERTIFICATE HOLDER CANCELLATION Additional Insured SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE I • ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) . The ACORD name and logo are registered marks of ACORD