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Home My WebLink AboutInsurance Certificate: Quality Fence Cos- A ® DATE (MMIDD/YYY CERTIFICATE OF LIABILITY INSURANCE 09/25/2024 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 endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Hart Insurance Agency NAME: Rristi Dolma e _ PO Box 1240 PHONE (541) 779-4232 No: E-MAIL Grants Pass OR 97528 ADDRESS: kdolmage@hartinsurance.com INSURED Quality Fence Co Po Box 3985 Central Point OR 97502 COVERAGES 3AIF KD CFRTIFICATF NIIMRFR• Cert TO 30140 (1121 RFVIRIr)NI NI IMRFR- 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 LTR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY NUMBER MM/DD POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMA ES( RENTED CLAIMS -MADE u OCCUR PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ POLICY D CT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE (par.. $ $ UMBRELLA LIAB OCCURI, EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DIED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N Y 738638 10/ 01/2024 10/01/2025 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE /M OFFICEREMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERAT!ONS below E.L. DISEASE - POLICY LIMIT S 1,000,000 -T- $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver for all written contracts applies CERTIFICATE HOLDER CANrFI I ATIrINI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, City Shops ACCORDANCE WITH THE POLICY PROVISIONS. 90 North Mountain Avenue AUTHORIZED REPRESENTATIVE Ashland OR 97520 U 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1 www.saif.com Carrier no: 20001 SAIF policy: 738638 Quality Fence Co ■ saifWork. Life. Oregon. Endorsement no: WC000313 (Ed. 430B) Waiver of Our Right to Recover from Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor name: Persons and/or organizations with whom the insured -employer is required by written contract to waive subrogation rights. This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective date: October 01, 2024 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. WC000313 (Ed. 430B) Countersigned September 20, 2024 at Salem, Oregon 1 Chip Terhune President and Chief Executive Officer 400 High Street SE Salem, OR 97312 P: 800.285.8525 F:503.373.8020 Pol_PC1_E430B