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Home My WebLink AboutInsurance Certificate: S & S Sheetmetal Inc (2) '4 �'� CERTIFICATE OF LIABILITY INSURANCE DATE(M7/ YYY) 03M2022026 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 CON ACI NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE HOME OFFICE:P.O.BOX 328 tArC,No,Ext):888-3334949 LAIC,No):507-446-4664 OWATONNA,MN 55060 E-MAIL ADDRESS:CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC} INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED INSURER B: S&S SHEETMETAL INC INSURER C: 912 ANTELOPE RD WHITE CITY,OR 97503-1607 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:126 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 NND MMIDDIYYYY MM/DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES $100,000 (Ea occurrence) MED EXP(Any one person) EXCLUDED A Y Y 9910853 04/24/2026 04124/2027 PERSONAL&ADV INJURY $1,000,000 GENE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000 000 POLICY X IE E]LOC PRODUCTS&COMP/OP ACC $2,000,000 OTHER: AUTOMOBILE LIABILITY EOM6INED SINGLE LIMIT $1,000,000 (Ea acclde X ANY AUTO BODILY INJURY(Per Person) A OWNED AUTOS ONLY Y N 9910853 04/24/2025 04/2412027 BODILY INJURY(Per Accident) HIRED AUTOS ONLY ]A5,CTHCEDULED NON-OAINED PROPERTY DAMAGE AUTOS ONLY (Per Accident) X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESSLIAB CLAIMS-MADE N N 9910854 04/24/2026 04/2412027 AGGREGATE $5,000,000 11 DED I RETENTION WORKERS COMPENSATION PER STATUTE OTHER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER!EXECUTIVE E.L EACH ACCIDENT OFFICER MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION THE CITY OF ASHLAND OREGON 126 0 20 E MAIN 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 J 0 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 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 S&S SHEETMETAL INC 912 ANTELOPE RD POLICY NUMBER WHITE CITY,OR 97503-1607 SEE CERTIFICATE#126.0 CARRIER NAIC CODE EFFECTIVE DATE:SEE CERTIFICATE#126.0 SEE CERTIFICATE#126.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE HOLDER NAME IS AMENDED TO READ THE CITY OF ASHLAND, OREGON ITS ELECTED OFFICIALS, OFFICERS 8 EMPLOYEES. PROJECT: HVAC SYSTEM INSTALL - NO. MOUNTAIN SHOP EFFECTIVE 07/28/14 SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY, ADDITIONAL INSURED INCLUDES CITY OF ASHLAND, OREGON, ALONG WITH ITS ELECTED OFFICIALS, OFFICERS, AND EMPLOYEES. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSORS 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. GENERAL LIABILITY CONTAINS A WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC ENDORSEMENT EACH CONSTRUCTION PROJECT AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT. ACORD 101 (2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [TCAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endonaement, 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 u joint venture, for which you have agreed by vvhMon contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of covered "auto" with your permission. Howmwsr, this additional insurance does not apply to: (1) The owner uranyone else from whom you hire or borrow covered "auto" This exception does notapp|yiftheooversd "auto" iau "trui|er" omnnectmdtnacovered "uuto" youpwn. (2) Your "employee" if the covered "auto" is owned by that "employee" or u member of his or her household. (3) Someone using u covered "auto" while he or she is working in a business of selling, mmrvioing, 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 u limited liability oonnpmny), or a lessee or borrower or any of their "emp|oyeea", while moving property ioor from a covered "uuto" (5) A partner (if you one a purtnmrship), or u member (if you are a limited liability company) for a covered "auto"owned by him or her ora member ofhis 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 tornna and conditions that are required by the terms of the written agreement to add any insured, orto procure insurance. C. The limits of insurance applicable to such insurance ahu|| be the lesser o/ 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 "|000" arising out ofthe sole negligence ofany person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the |aueor or his or her agent takes possession of the leased nr rented ^uuto"or the policy period ends, whichever occurs first. Includes copyrighted material of Insurance Services 0ffioo. Inc. with its permission. CA-F-127 (03-03) Policy Number: 0810853 Transaction Effective Date: 04/24/2020 COMMERCIAL GENERAL LIABILITY CG20011219 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 (2) You have agreed in writing in a contract Condition and supersedes any provision to the or agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. 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 O Insurance Services Office, Inc., 2018 Page 1 of 1 CG 20 01 12 19 Policy Number: 9910853 Transaction Effective Date: 04/24/2026 COMMERCIAL GENERAL LU\8|LUY CG2O33121S THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDIT��K�U��U U��U �� LESSEES �� IONAL u��o��m� m"��*xxu�� xmm~ox=,� u~�~�=vm�m�� vv �� U��U� �� CONTRACTORS n�� m ��"x=� AUTOMATIC��nwnr�o n�~ STATUS��w �� WHEN REQUIRED U�� U�� CONSTRUCTION ��U U��U�� n*m��nnvu~�� um� �n WRITTEN. ��m� ��x�� n nx��o u��o� ��A��U�� 0�U�� `��UK AGREEMENT WITH x n YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section || - Who Is An |nmwmsd is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional inaurods, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contract or agreement that such person or organization be 1' "Bodily injury", "property damage" or "personal and advertising injury" arising out of added as an additional insured on your policy. Such person or organization is on additionalthe rendering of, or the failure to nender, any insured only with respectto liability for "bodily professional architectura|, engineering or uurveyingservioeo. including: injury", "property damage" or "personal and advertising injury"caused, in whole or in purt, by: o. The preparinQ, approving, or failing to 1. Your acts or omissions; or prepare or approve, mapo, shop dravvingo, opinions, reporta, surveyu, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications; or in the performance uf your ongoing operations for b. Supervioory, inapection, architectural or the additional insured. engineering activities. Howevmr, the insurance afforded to such This exclusion applies even if the o|mimo additional insured:' against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the mupmrviaion, hiring, and emp|oyment, training or monitoring of others 2. Will not be broader than that which you are by that ineured, if the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. damage°, or the offense which caused the "personal and advertising iniury" involved the A p�rsmn's or organi�ation'a status �� an ' additional insured under this endorsement ends rendering of or the failure to render any professional architectural, engineering or when your operations for that additional insured surveying services. are completed. @ Insurance Services Office, Inc., 2018 Page of 2. "Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional inaureds, the following is added to s- All vvork, including materiu|u, parts or Section III - Limits 0fInsurance: equipment furnished in connection with The most we will pay on behalf ofthe additional such work, on the project (other than insured is the amount ofinsurance: aervice, maintenance or repairs) to be 1- Required by the contract or agreement you performed by or on behalf additional have entered into vviththe additional insured; insured(s) at the location of the covered ' operations has been completed; or or b. That portion of "your work" out of which insurance; Available under the applicable limits of ----- the injury or damage arises has been put to its intended use by any person or whichever imless. organization other than another contractor This endorsement shall not increase the or subcontractor engaged in performing applicable limits ofinsurance. operations for a principal as o part of the same project. Page 2uf2 Q Insurance Services Office, Inc., 2018 COMMERCIAL GENERAL LIABILITY CG24531219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV-Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. O Insurance Services Office, Inc., 2018 Page 1 of 1 CG 24 53 12 19 Policy Number: 9910853 Transaction Effective Date: 04/24/2026 � � POLICY NUMBER: 9910853 COMMERCIAL GENERAL LIABILITY CG25O3O5U9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ Il[ CAREFULLY. ��U�� U�� U�� *��m��x�� u ��~ ��u�~� xnv��o .��"� x- "v��n�m�� u �� U��N �� ~�� LIMIT `��"m�n�x�� AGGREGATE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Each construction project as required by written contract or written Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3' Any payments made under Coverage & for obligated to pay as damages caused by damages or under Coverage C for medical ,occurrences" under Section | Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section | Coverage C. which can be for that designated construction project. Such attributed only 'to ongoing operations at m single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction pnoject, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Ocourrenou, Damage To Premises Rented To 2- The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the Hovvever, instead of being subject to the sum of all damages under Coverage A. except General Aggregate Limit shown in the damages because of "bodily injury" or DedaraUona, such limits will be subject iothe "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate LinniL expenses under Coverage C nogurd|eoo of the number ut m. Insureds; b. Claims made ur "ouits" brought; nr c. Persons or organizations making claims or bringing "suito" B. For all aunno which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard" is "occurrences" under Section U Coverage A, and provided, any payments for damages because of for all nmodiou| expenses caused by accidents "bodily injury" or "property damage" included in under Section I ' Coverage C. which cannot be the "prod uctu-oornp|eded operations hazard" will attributed only to ongoing operations at e single reduce the Prod uoty'oonnp|ated Operations designated construction project shown in the Aggregate Limit, and not reduce the C;onero| ----- Schedule above: Aggregate Limit nor the Designated Construction � 1^ Any payments made under Coverage & for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project � expenses shall reduce the amount available has been abandoned, delayed, orabandoned and under the General Aggregate Limit or the then neutartmd, or if the authorized contracting Prod uota-comnp|eted Operations Aggregate parties deviate from p|ana, blueprints, designs, � Limit, whichever io applicable; and npmoiUcuUonm or tirnetab|em, the project will still � 2. Such payments shall not reduce any be deemed tobothe same construction project. Designated Construction Project General E. The provisions of Section 8I| Limits Of Insurance Aggregate Limoii not otherwise modified by this endorsement shall continue toapply as stipulated. Page 2 of 2 Q Insurance Services Office. Inc., 2008 [G 25 03 05 09