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Home My WebLink AboutInsurance Certificate: S & S Sheetmetal Inc_7f . ,4&CvkL' CERTIFICATE OF LIABILITY INSURANCE (MMIDDfY ' 03/29/2024 024 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 FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 OWATONNA MN $5060 NAME GT CLIENT CONTACT CENTER PHONE — - IAlC, No, Ertl: 888-333.4949 FAX e, No): 507-446-4664 wooREss:CLIENTCONTACTCENTER FEDINS.COM INSURERS AFFORDING COVERADE NAIC k INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 343-547-6 S & S SHEETMETAL INC INSURER e: FEDERATED RESERVE INSURANCE COMPANY 16024 INSURER C: 912 ANTELOPE RD WHITE CITY, OR 97503-1607 INSURER D: INSURER E: COVERAGES INSURER F: CERTIFICATE NUMBER. 126 REVISION NIIMRFR• n 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, IN R TYPE OF INSURANCE ADDL SUBR POLICY NUMBER P Y EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $1,000,000 AMAGE TO RENTED PREMISES r. $100,000 EXCLUDED B Y Y 9910853 04/24/2024 04/24/202$ MED EXP IAny one person) PERSONALS ADVINJURY 1000 ODO AGGREGATE LIMIT LIIMIT APPLIES PER: POLICY L-LECTT L� GENERAL AGGREGATE GENIE PRODUCTS SCOMP/OP AGO $2,000,000 OTHER'. BOWNED AUTOMOBILE JANYAUTO LIABILITY AUTOS ONLY ASCTHRULED Y N 9910853 04/24/2024 04/24/2025 COMBINED SINGLE LIMIT Ea acclden $1,000,000 BODILY INJURY IPer Person) BODILY INJURY (Par AccidanQ HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE )t UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESSLIAB CLAIMS -MADE N N 9910854 D4/24/2024 04/24/2025 AGOREGATE $5,000,000 DED I IRETENTIOIN WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / ANY PROPRIETOR/PARTNER/ EXECUTIVE PER STATUTE OTHER El EACH ACCIDENT OFFICERIMEMBER EXCLUDED? L (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A E.L DISEASE EA EMPLOYEE E.L DISEASE • POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Sduduk, may he attached it mom space is required) SEE ATTACHED PACE KMI rr!bMIG nvustc CANCELLATION 343-547-6 THE CITY OF ASHLAND OREGON 20 E MAIN ST ASHLAND, OR 97520-1814 126 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 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2015103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 343-547-6 LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAM EDINBURED FEDERATED MUTUAL INSURANCE COMPANY S S INC RD 912 ANTELOPE RD 2 ANTELOPE WHITE CITY, OR 97503-1607 POLICY NUMBER SEE CERTIFICATE # 126.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 126.0 SEE CERTIFICATE # 126.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE HOLDER NAME IS AMENDED TO READ THE CITY OF ASHLAND, OREGON ITS ELECTED OFFICIALS, OFFICERS & EMPLOYEES. PROJECT: HVAC SYSTEM INSTALL - NO. MOUNTAIN SHOP EFFECTIVE 07/28/14 THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE. GENERAL LIABILITY CONTAINS A WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC ENDORSEMENT EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. ACORD 101 (2008/01) 0 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 343-547-6126 #B W N D H BS BUOOO-03 - 0012 #XWXW0021 XXXXXXX5# THE CITY OF ASHLAND OREGON 20 E Main St Ashland, OR 97520-1814