Loading...
HomeMy WebLinkAboutInsurance Certificate : Owen Equipment Holdings Corp. i �® CERTIFICATE OF GARAGE INSURANCE DATE/2/202/WYE • 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 Sentry Customer Service Sentry Insurance NAME: 1800 North Point Drive WC No,Ext): 800-473-6879 FAX No):800-514-7191 Stevens Point,WI 54481 EMAIL ADDRESS: businessproducts_directesentry.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentry Select Insurance Company 21180 INSURED INSURER B: Owen Equipment Holdings Corp INSURER C 4201 NE 66th Ave Ste 105 Vancouver,WA 98661-3078 INSURER D: INSURER E: INSURER F: COVERAGES PROD/CUSTOMER ID: CERTIFICATE It: 2399666 REVISION It: 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MM/DD/YYYY) (MM/DD/YYYY) GARAGE LIABILITY HIRED AUTOS AUTO ONLY(Ea accident) $500,000 X ANY AUTO —ONLY A _ NON-OWNED X A0186988001 11/09/2021 11/09!2022 EA ACCIDENT OWNED —AUTOS USED OTHER THAN $500,000 AUTOS ONLY IN GARAGE BUSINESS AUTO ONLY AGGREGATE $2,500,000 GARAGE KEEPERS LIABILITY , COMP/ OTC LOC 1 $1,000,000 — LEGAL LIABILITY RuilEIED LOC $ A DIRECT BASIS X A0186985001 11/09/2021 11/09/2022 X. COLLISION LOC 1 -$1,000,000 PRIMARY n EXCESS LOC $ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE El OCCUR PREMISES Eaoccurrrence) $ — MED EXP(Any one person) $ —, PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ — POLICY El Tei E LOC PRODUCTS-COMP/OP AGG $ OTHER X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $10,000,000 A x EXCESS LIAB CLAIMS-MADE A0186985008 11/09/2021 11/09/2022 AGGREGATE $30,000,000 DED RETENTION$ PRODUCTS-COMP/OP AGG $30,000,000 WORKERS COMPENSATION X STAOTHTUTE ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE N/A A0186985007 11/09/2021 11/09/2022 E.L.EACH ACCIDENT $1,000,000 A OFFICER/MEMBER EXCLUDED? Y/N (Mandatory in NH) ❑ E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under ' REMARKS below E.L.DISEASE-POLICY LIMIT $1,000,000 REMARKS(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Refer to attached , CERTIFICATE HOLDER • CANCELLATION 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 ACCORDANCE Ashland,OR 97520-1814 WITH THE POLICY PROVISIONS. AUT IRF{�Z�p.BEEB NTATIV /( u;: ACORD 30(2016/03)• Page 1 of 2 ��({/ ©2010-2(0/15 ACORD CORPORATION.All rights reserved. A0186985 The ACORD name and logo are registered marks of ACORD 12/21/2021 Sentry Select Insurance Company • 3 00002 0000001385 21355 N A 0 89709AC0-ED3A-4AC6-B9CB-B4F32EBBOO6A 0027020044363527503197520184920 AGENCY CUSTOMER ID:)X0000(6853 ACORD LOC#: �•.. ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Cameron Scott Owen Equipment Holdings Corp POLICY NUMBER A0186985001 CARRIER NAIC CODE Sentry Select Insurance Company. 21180 EFFECTIVE DATE: 11/09/2021 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 30 FORM TITLE: Certificate Of Garage Insurance Auto Dealers The City of Ashland, Oregon, its Officers, Agents and Employees are named as Additional Insured on a Primary and Non-Contributory basis. General Liability is included within the Garage Liability(including products/completed operations). Garagekeepers Liability Location# State Basis Collision Limit Comp/OTC/Specified Perils Limit 2 UT Natural Disasters Legal $ 3,250,000 $ 3,250,000 Liability 3 CA Natural Disasters Legal $ 1,000,000 $ 1,000,000 Liability 4 WA Natural Disasters Legal $ 1,000,000 $ 1,000,000 Liability • • • ACORD 101(2008/01) ©2008 ACORD CORPORATION. All rights reserved. A0186985 The ACORD name and logo are registered marks of ACORD Sentry Select Insurance Company 12/21!2021 •