HomeMy WebLinkAboutInsurance Cancellation: Debra Kenny dba Just Bugs Pest Control ACOREP CERTIFICATE OF LIABILITY INSURANCE DATE(W•WDDTYYYY)
.�� 03/03/2022
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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME: Reed
Insurance Marketplace,Inc (541)77 -
(ac°N o.E ct): 9 0177 FAX No); (541)772-8235
PO Box 278E-MAIL
ADDREss: debbie@insmarket.com
•
INSURER(S)AFFORDING COVERAGE NAIC#
Medford OR 97501 INSURER A: Mesa Underwriters Specialty Insurance Co. 36838
INSURED -
INSURER'B: -
Debra Kenny DBA:Just Bugs Pest Control INSURER C:
PO Box 746 INSURER D: I
INSURER E:
Eagle Point OR 97524- 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.
LTR TYPE OF INSURANCE ADOLISUBR POLICY EFF POLICY EXP LIMITS
INSD WVD POLICY NUMBER (MMtDD/YYYY) (MM/DD(YYYY)
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
DAmAGETO-FiENCLAIMS-MADE X OCCUR PREMISES a occu I ence) $ 100,000
_ MED EXP(Any one person) $ 5,000
A Y MP0046003016864 03/01/2022 03/01/2023 PERSONAL&ADV INJURY_ $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 2,000,000 _
X POLICY j JE a LOC PRODUCTS-COMP/OP AGG $ Included
OTHER: y $
AUTOMOBILE LIABILITY C A N C L L!!� P CO BINEDtSINGLELIMIT $
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS eh• Rate Pro Ralto. Q BODILY INJURY__. (Per accident) $
HIRED AUTOS N ONLY �� g« PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY ®atl�� (Per accident) $
UMBRELLA LIAB OCCUR— EACH OCCURRENCE
Poi{cy,_ Reg. Not—L„P.F1...... $
EXCESS LIAB CLAIMS-MADE as , AGGREGATE _ $
DED j RETENTION$ To Company $
WORKERS COMPENSATION I STATUTE ERH
AND EMPLOYERS'LIABILITY Y/N • ..�-.,�.rswr ---- `-`
ANYPROPRIETOR/PARTNER/EXECUTIVEN t A E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) E.L,DISEASE-EA EMPLOYEE $ -
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES'(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
City of Ashland,It's Officers,Agents and Employees are named as Additional Insured(s)per form CG 2012(04/13)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland,It's officers,Agents and Employees ACCORDANCE WITH THE POLICY PROVISIONS.
20 East Main Street •
AUTHORIZED REPRESENTATIVE
Ashland OR 97520
I @ 1988-2015 ACOR(y.
ORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD •