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HomeMy WebLinkAboutInsurance Certificate: TC Chevrolet IncACIURDI CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) �...- 01/22/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATVELY 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 team 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 NAME CT CLIENT CONTACT CENTER IA,cNNo, Ertl: 888-333-4949 FAXNo): 507-446-4664 ADDRIESS:CLIENTCONTACTCENTER FEDINS.COM INSURERS AFFORDING COVERAGE NAIC // INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED 276-176-5 TIC CHEVROLET INC INSURER B: INSURER C: PO BOX 249 INSURER 0: ASHLAND, OR 97520-0249 INSURER E: rnveeen_ee INSURER F: w•�a:cKIIFICAIE NUMBER: 1 REVISION NIIMRFR D 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. ILTR NSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POI Y EFF POLICY E%P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $500,000 AMAGE TO RENTED PREMISES $100,000 CLAIMS -MADE ❑X OCCUR $5,000 A Y N 9918174 03/01/2024 03/01/2025 ME EXP (Any one person) PERSONAL& ADV INJURY $500,000 AGGREGATE �LIM�IT APPLIES PER: POLICY L_4ECT ❑LDC GENERAL A GREO 0 0 GEN'L MOTHER: PRODUCTS & COMP/OP AGO $1,000,000 AUTOMOBILE LIABILITY COMBINED SINOLE LIMIT Ea a.,d.nt ANY AUTO BODILY INJURY (Per Person) OWNED AUTOS ONLY AC&DULED BODILY INJURY (Par Accident) HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE citlen� A X UMBRELLA LOB EXCESS LIAB X OCCUR CLAIMS -MADE N N 9918175 03/01/2024 03/01/2025 EACH OCCURRENCE _ AGGREGATE $15,000,000 lD I IRETENTICN WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERI EXECUTIVE OFFICERIMEMBER EXCLUDED? L Mandatory Iredo If yes, descrlDe under (,I/A PER STATUTE OTHER E.L EACH ACCIDENT E.L DISEASE fA EMPLOYEE E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS balm DEALER LIABILITY N N 9918174 D3/01/2024 03/01/2025 AUT0 LIAB-EA ACCIDENT $500,000 A [UTO GENERAL LIABILITY - EACH ACCIDENT $500,000 -AGGREGATE $1,000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATEHOLDER IS AN ADDITIONAL INSURED FOR GENERAL LIABILITY. �zR1iFiCAlE HOLDEN: CANCELLATION 276-176-5 CITY OF ASHLAND 20 E MAIN ST ASHLAND, OR 97520-1814 1 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE / /li /I n v"'"- ` © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 9918174 COMMERCIAL GENERAL LIABILITY CG20241219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS OR OTHER INTERESTS FROM WHOM LAND HAS BEEN LEASED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Land Name Of Person(s) Or Organization(s) (Part Leased To You) City of Ashland 2045 Highway 99 N 20 E Main St Ashland, OR 97520-9653 Ashland, OR 97520 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you and shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to lease that land; Insured: TC Chevrolet Inc PO Box 249 Ashland, OR 97520-0249 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Regarding: 403 Dead Indian RD, Ashland, or © Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 24 12 19 Policy Number: 9918174 Transaction Effective Date: 03/01/2024 276-176-5 1 #B W N D H BS BNOOO-05 - 0174 #XWXW0021 XXXXXXX5# CITY OF ASHLAND 20 E Main St Ashland, OR 97520-1814