HomeMy WebLinkAboutInsurance Certificate: Phoenix Automotive Center IncAC"R"
�' CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD VYYY)
F05/08/2024
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 erwbrsement. 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
NAME CT CLIENT CONTACT CENTER
1A%CNNo, Ertl: 888-333-4949 jA e, No): 507-446-4664
OWATONNA, MN 55060
ADORIESs:CLIENTCONTACTCENTER FEDINS.COM
INSURERS AFFORDING COVERAGE
NAIC f/
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY
13MS
INSURED 339-395-6
INSURER a: FEDERATED RESERVE INSURANCE COMPANY
16024
PHOENIX AUTOMOTIVE CENTER INC
PO BOX 519
INSURER C:
INSURER D:
PHOENIX, OR 97535-0519
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1 REVISION NUMBER: 0
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.
IH
TYPE OF INSURANCE
ADDL
POLICY NUMBER
POLICY EFFty,
PO1yYYyy,
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
BUSINESS OWNER'S LIABILITY
N
N
9365712
07/01/2024
07/01/2025
EACH OCCURRENCE
$1,000,000
AMAOE TO ELATED PREMISES
s100,000
X
MED EXP (Any one person)
OEN'L
X
PERSONAL& ADVINJURV
$1.0oo,00o
AGGREGATE LIMIT APPLIES PER:
POLICY �ELOC
OTHER:
GENERAL AGGREGATE
000
PRODUCTS & COMP/OP AGO
$ ,000,000
B
AUTOMOBILE LIABILITY
X ANYAUTO
OWNED AUTOS ONLY ASCFEDULED
HIRED AUTOS ONLY AUT���
N
N
9365713
07/01/2024
07/01/2025
COMBINED SINGLE LIMIT
Ea acc den
g1,000,000
BODILY INJURY (Per Person)
BODILY INJURY (Par AccidenO
ROPERTY AMAGE
A
X
UMBRELLA LIAB
EXCESB
SLIA
X OCCUR
ct.Aims-MADE
N
N
9365716
07/01/2024
07/01/2025
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2,000,000
DED RETENTION
WORKERS COMPENSATION
WAND EMPLOYERS' LIABILITY I
ANY PROPRIETORIPARTNEW EXECUTIVE
OFFICER/MEMBER EXCLUDED?
JIM ndstory In NH)
11 Yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
P ER STATUTE OTHER
El EACH ACCIDENT
El DISEASE EA EMPLOYEE
El DISEASE POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Ad60unsl Remarks Sdndule, may be atYehed IN more space is requiredl
CERTIFICATE HOLDER CANCELLATION
339-395-6
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 , v
O 1988-201S ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD