Loading...
HomeMy WebLinkAboutInsurance Certificate: Jahnke Heating & Air Conditioning Inc (2)1 ® AC r' CERTIFICATE OF LIABILITY INSURANCE DATE JMMIDDNYYYi 02/1912025 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 poiicy(les) 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 eadorsement(s). PROOUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE- P.O. BOX 328 OWATONNA, MN 55060 CONtAul NAME, CLIENT CONTACT CENTER -PHONE'-' TAx' (A1C, No, EXIT! US-333-4949 tJuc, Rol: 5074464%4 E-MAIL AooREss: CLIENTCONTACTCENTER®FEDINS.COM m INSUNfRS AFFORDING COVERAGE NAIC # INSURER A:FEDERATED RESERVE INSURANCE COMPANY 1W24 INSURED JAHNKF HEATING 8 AIR CONDITIONING INC 112 S PACIFIC HWY TALENT, OR 97W-66,46 INSURER B: rksURPR G: ' INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 95 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. NOTWITHSTAND#NG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W)TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. W$R LTR TYPE OF INSURANCE ADDL INSR SUER WVG POLICY NUMBER POLICY EFP MMIAUIYYY POUCY EXP JAM10bIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAMS -MADE OCCUR Y N 9059608 04108/2025 04/0812026 EACH OCCURRENCE $1,000,000 ce ELATED PREMIS ES occwreabAMACE TO fa $1�� MED EXP(Any— person} EXCLUDED PERSONAL 8 AOV INJURY $1,000,OOD PENT. X AGGREGATE LIMIT APPLIES PER: POUCY �CO- LOC OTHER: GENERAL AGGRECATE PRODUCTS 3 COMPIOP ACC $2,000,000 A AUTOMOMI-r LIABILITY X ANYALITO OWNED AUTOS ONLY SAVTHE�UULED HIRFI) AUTOS ONLY �NOIJ-OY^'E� AUTOS O*!L Y N 9089W8 04/08/2025 04/08/2026 COMBINED SINGLE LIMIT (Ea accidenQ $1 OQD m0 BODILY INJURY (Per Psrsonl BODILY INJURY (Per Accident) ROPERTY bA+hAOL Per Aaidan A X UMBRELLA LVLH EXCESSLUIB X OCCUR CLAUAS-MADE N N 9089609 04108f2D25 04MM026 EACH OCCURRENCE $1,000,000 AGOREOAT£ $1,000,000 LIED I RETENTIQJ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERI EXECUTIVE OMCERrMEMB£R EXCLUUEU4 (Mandatory in NMI If yes. desuibe seder DESCRIPTION OF OPERATIGNS b-k W R11A PER STATUTE DTHER El EACH ACCIDENT El DISEASE EA EMPLOYEE E.L DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS 1 VFRICLES (AcORD 101, Additonal Remarks SdIsWe, may be atUdw4 Ir more space Is regtireai SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 20 E MAIN ST ASHLAND, OR 97SM-1814 950 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 IM-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (201SIM) The ACORD name and logo are registered marks of ACORD Ac'"" le ✓. AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of AGE=Y nAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY JAHNKt; HEATING & AIR CONDITIONING INC 112 S PACIFIC HVVY TALENT, OR 97540.6648 PDL.CY rnUMaER SEE CERTIFICATE # 95.0 CARNIER NAIC CODE_2___ EFFECTIVE DATE: SEE CERTIFICATE fl 95.0 SEE CERTIFICATE # 95.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL INSURED ALSO INCLUDES THE CITY OF ASHLANO, OREGON, ITS OFFICERS, AGENTS AND EMPLOYEES THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. INSURANCE PROVIDED BY THE GENERAL LIABILITY COVERAGE IS PRIMARY AND NONCONTRIBUTORY OVER OTHER INSURANCE SUBJECT TO THE CONDITIONS OF THE PRIMARY AND NONCONTRIBUTORY CLAUSE- OTHER INSURANCE CONDITION. ACORD 101 (2008/01) 0 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto" with your permission. However, this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto'. This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own. (2) Your "employee" if the covered "auto' is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a member (if you are a limited liability company) for a covered "auto" owned by him or her or a member of his or her household. B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured, or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To "loss" which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto' when the lessor or his or her agent takes possession of the leased or rented "auto' or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA-F-127 (03-03) Policy Number: 9089608 Transaction Effective Date: 04/08/2025 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Policy Number: 9089608 Page 1 of 1 Transaction Effective Date: 04/08/2025 COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", „property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. © Insurance Services Office, Inc., 2018 Page 1 of 2 CG 20 33 12 19 Policy Number: 9089608 Transaction Effective Date: 04/08/2025 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9089608 Transaction Effective ©ate: 04/08/2025 10--f- 191*111*17 #BWN©HBS BK000-04-0342 #XWXWO021 XXXXXXX5# CITY OF ASHLAN© 20 E Main St Ashland, OR 97520-1814