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Home My WebLink AboutInsurance Certificate: TC Chevrolet Inc CERTIFICATE OF LIABILITY INSURANCE DATE 0211IDD(M21202 YYY) N III�H 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(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 CUNIACt NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE:P.O.BOX 328 IAIC,No,Ext):888-333-4949 fntc,No):507 446 4664 OWATONNA,MN 55060 AOORrss:CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC## INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED INSURER 0: TC CHEVROLET INC INSURER C: PO BOX 249 ASHLAND,OR 97520-0249 INSURER D: INSURER E: INSURER R 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WW MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $500,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES $100,000 Ea occurrence} MED EXP(Any one person) $5,000 A Y N 9918174 03/01/2026 03/01/2027 PERSONAL All INJURY $500,000 AEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1,000 000 X POLICY �E T ❑LOC PRODUCTS&COMPIOP ACC $1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accidenf) ANYAUTO BODILY INJURY(Per Parson) OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY(Par Accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY (Per Accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $15,000,000 A FXCFSSLIAB CLAIMS-MADE Y N 9918175 03/01/2026 03101/2027 AGGREGATE $45,000,000 DELI I RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN PER STATUTE THER ANY PROPRIETORTARTNERI EXECUTIVE E.L EACH ACCIDENT OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) El DISEASE EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT [TO DEALER LIABILITY Y N 9918174 03101/2026 03/01/2027 AUTO LIAB-EA ACCIDENT $500,000 A GENERAL LIABILITY -EACH ACCIDENT $500,0(i0 -AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 1e1,Additional Remarks Schedule,may be attached if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND 10 20 E MAINN ST SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ASHLAND,OR 97520-1814 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2016 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ' ? LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY TC CHEVROLET INC PO BOX 249 POLICY NUMBER ASHLAND,OR 97520-0249 SEE CERTIFICATE#1.0 CARRIER NAIL CODE EFFECTIVE DATE_SEE CERTIFICATE#1.0 SEE CERTIFICATE#1.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE GARAGEKEEPERS COVERAGE IS PROVIDED ON A DIRECT PRIMARY BASIS WITH A LIMIT OF $2,300,000 FOR: 2045 HIGHWAY 99 N ASHLAND, OR 97520-9653, 3001 BIDDLE RD MEDFORD, OR 97504-4118, 3103 BIDDLE RD MEDFORD, OR 97504-4120 898 LAWNSDALE AVE MEDFORD, OR 97504-4014 908 LAWNSDALE AVE MEDFORD, OR 97504-4015 THE CERTIFICATE HOLDER IS A DESIGNATED INSURED ON BUSINESS AUTO LIABILITY SUBJECT TO THE CONDITIONS OF THE DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. ACORD 101 (2008/01) Q 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 9918174 COMMERCIAL AUTO CA 204010 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. U��U��U� ��U��U� ��U� ��°�.��mnmr�m �� mum��nmm~�� FOR ��U� �� N COVERAGE °�n�,��x�m~�� m"="�� m�m��m�o�� m n �*��m�ua��m� This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endonuemnent, the provisions of the CnvaroQo Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds"for Covered Auto Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement duom not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy un|ooa another date is indicated below. Named Insured: TC Chevrolet Inc Endorsement Effective Date: 03/01/2026 SCHEDULE Name of Person(s) Or Organization(s): City of Ashland 20 E Main St Ashland, OR 97520 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Cuvoraga, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1- of Section U| - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. POLICY NUMBER: Q91074 COMMERCIAL GENERAL LIABILITY CG 20 2482 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. �U�U�U��U��U��N NU��UUU��U� ~ ��U�� ^�K�� ~��v . y��u��m~ on��m��~ ��m�u�� *n� �� m ��o� W�� U� ��U� LAND �� LEASED un� m ��m��/�'n �� FROM �� u��n�o m��"�� x *�� mm~m�.� This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Land Name Of Person(s) Or Organization(s) (Part Leased To You) City of Ashland 2045 Highway 99 N 20 E Main St Ashland, OR 97520-9653 Ashland, OR 97520 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 81 - Who Is An Insured is amended to 2' Structural u|toradinnn, new construction or include as an additional insured the peraon(n) or demolition operations performed by or on organization(o) shown in the Snhedu|e, but only behalf of the person(s) or organization(s) with respect to liability for "bodily hnjury", shown in the Schedule. "property damage" or "personal and advertising C. With respect to the insurance afforded to these injury" caused, /n whole or /n pan, by you or additional inaureda, the following is added to those acting on your behalf in connection with the Section III - LUmmitmOf|msurance: ovvnerohip, maintenance or use of that port of the land leased toyou and shown in the Schedule. If coverage provided to the additional insured is However: required by m contract oragreement, the most we will pay on behalf of the additional insured is the 1 The insurance afforded to such additional ^ amount ufinourano�� insured only applies tothe extant permitted by law; and n~ Required by the contract or agreement; or 2. If coverage providedhztho additional insured 2~ Available under the applicable limits of is required by e contract or agreennent, the insurance; insurance afforded hosuch additional insured whichever is |eon will not be broader than that which you are � required by the contract or agreement to This endorsement shall not increase the provide for such additional insured. applicable limits mfinsurance. B. With respect to the insurance afforded to these additional inauredm, the following additional exclusions apply: This insurance does not apply to: 1' Any "nccurrence" which takes p|eoa after you cease tm lease that |and' , Insured: Regarding: TCChevno|et Inc 403 Dead Indian RD. Ashland, or PU Box 249 Ashland, OH0752O-O24Q (D Insurance Services Office, |no, 2D18 Page 1of1 2T6-175-51 #BVVNDHBS aDO03-070187 #>000<VV0021)O0<X>Q{X5# ---- CITY OFASHLANO 20 E Main 8t Ashland, ORQ752O-1D14 '