HomeMy WebLinkAboutInsurance Certificate: Kaylor Electric LLCA� �® CERTIFICATE OF LIABILITY INSURANCE
7TE04 29/20 5 YYI
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 pollcy(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 endorsement(s).
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANYFAX
HOME OFFICE: P.O. BOX 328
OWATONNA, MN 55060
NAME: CLIENT CONTACT CENTER
(A/C, No, E.U: OW333-490 IA/e, No): 507-446-4664
ADDRESS. CLIENTCONTACTCENTER FEDINS.COM
INSURERS AFFORDING COVERAGE
NAIC /J
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED
INSURER B: FEDERATED RESERVE INSURANCE COMPANY
16024
INSURER C:
KAYLOR ELECTRIC LLC
PO BOX 639
PHOENIX, OR 97535-0639
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 13 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MMIDD/YYVV
POLICY EXP
MMIDDIYYYY
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OOCCUR
BUSINESS OWNER'S LIABILITY
N
N
9118896
07/01/2025
07/01/2026
EACH OCCURRENCE
$1,000,000
Ee oAGE [cu,. ENiED PREMISES
$100,000
X
MED EXP (Any one person)
PERSONAL S ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 0
OENL
J(
AGGREGATE LIMIT APPLIES PER:
POUCY �CCT ❑ LOC
OTHER:
PRODUCTS S COMP/OP ACC
$2,000,000
B
AUTOMOBILE LIABILITY
X ANYAUTO
OWNED AUTOSONLY AU7MULED
HIRED AUTOS ONLY A
N
N
9118897
07/01/2025
07/012026
(E MccdenCOBINuSINOLE LIMIT
$1,000,000
BODILY INJURY (Per Person)
BODILY INJURY IPerAcddmQ
(PRO
UMBRELLA LIAR
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AOOREOATE
DED I RETENIICN
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/ EXECUTIVE
OFFICERIMEMBER EXCLUDED? L
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER STATUTE DTHER
E.L EACH ACCIDENT
E.L DISEASE 1EA EMPLOYEE
E.L DISEASE POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required)
CERTIFICATEHOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE
CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
FOR BUSINESSOHNERS LIABILITY.
r-COTIClrATc unl nFD CANCELLATION
CITY OF ASHLAND
20 E MAIN ST
ASHLAND, OR 97520-1814
13 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
Ali le
O 1SM-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD