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HomeMy WebLinkAboutInsurance Certificate: Etzel Enterprises Inc (4) AC; DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 01/25/2023 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(les) must be endorsed. If SUBROGATIONIS 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 Ileu of such endorsement(s). PRODUCER CONTACT NAME: RICH BENEFITS PHONE (801)664-4454 34471250 FAX (A/C,No,Ext): (A/C,No): 1674 WEST ALPENGLOW CIRCLE E•MAILADDRESS: FARMINGTON UT 84025 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Hartford Fire and Its P&C Affiliates 00914 INSURED INSURER B: , ETZEL ENTERPRISES INC INSURER C: 3500 VICKSBURG LN N STE 411 INSURER D MINNEAPOLIS MN 55447 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,NOTWITHSTANDINQ ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS c 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR JNSR WVD (MM/DD/YYYY) (MM/DD/YIYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE - CLAIMS-MADE❑OCCUR ' DAMAGE TO RENTED PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE az POLICY❑JECT PRO EllLOCPRODUCTS-COMP/OP AGG OTHER: m. AUTOMOBILE LIABILITY • COMBINED SINGLE LIMIT (Ea accident)_ ANY AUTO = BODILY INJURY(Per person) —ALL OWNED SCHEDULED " BODILY INJURY(Per accident) _AUTOS _AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) _ UMBRELLA MB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS- AGGREGATE , MADE DED RETENTION$ WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY Y/N E.L.EACH ACCIDENT $1,000,000 A PROPRIETOR/PARTNER/EXECUTIVE — N/A 34 WEG AV9J85 01/09/2023 01/09/2024 — - OFFICER/MEMBER EXCLUDED? E L DISEASE-EA EMPLOYEE $1,000,000 — (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) Those usual to the Insured's Operations. 1 CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 90 North Mountain Avenue BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED Ashland OR 97520 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ..I'ue-�i X Caves ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ` 1 THE HARTFORD 0„r•.-` BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 ' January 25, 2023 SP 01-000108 51421 H 1 BSNGLP 111"1IIhIIh111111II1IhIhr111111IIhhI1II1III11II11in1luuIItll City of Ashland 90 North Mountain Avenue Ashland OR 97520-2014 N 0 O O Account Information: E1 Contact Us' Policy Holder Details : ETZEL ENTERPRISES INC1111111111 Need Help? Chat online or call us at (866)467-8730. I � We're here Monday- Friday. Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any -772 questions or concerns. Sincerely, I Your Hartford Service Team WLTR005