HomeMy WebLinkAboutInsurance Certificate: Countryside Electric Inc. DATE(MMtDD/YYYY)
'`� a CERTIFICATE OF LIABILITY INSURANCE 06/1212026
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 ruts to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME: CLIENT CONTACT CENTER AX
FEDERATED MUTUAL INSURANCE COMPANY oNE
(Arc,No,Eat):888 333 4949 {A1C,No):507 946-i664
HOME OFFICE:P.O.BOX 328
OWATONNA,MN 55060 E-MAIL
ADOREss:CLIENTCONTACTCENTER@FEDINS.COM
INSURERS AFFORDING COVERAGE NAIC 4
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED INSURER B:
COUNTRYSIDE ELECTRIC INC. INSURER C:
PO BOX 395 INSURER D:
TURNER,OR 97392-0395
INSURER E:
INSURER F: '..
COVERAGES CERTIFICATE NUMBER:9 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.
rA
ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
TYPE OF INSURANCE INSR WVD MM/DDIYYYY MMlDD1YYYY
EACH OCCURRENCE $1,000,000
COMMERCIAL.GENERAL LIABILITY pp --
CLAIMS-MADE aOCCUR {Ee ocairren�}ELATED PREMISES $100,000
X BUSINESS OWNER'S LIABILITY MED EXP(Any one pemcn)
N N 1902752 08/05/2026 08/05/2027 PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,
P000
GEN AGGREGATE LIMIT APPLIES PER:
I
POLICY �JECT
❑LOC PRODUCTS&COMPlOP ACC $2,000,000
OTHER:
COMBINED SINGLE LIMIT $1,000,000
AUTOMOBILE LIABILITY (Ea accident)
BODILY INJURY(Per Person)
X ANYAUTO
A OWNED AUTOS ONLY EULED N N 1902753 08105l2D26 08/05/2027 BODILY INJURY(Per Accident)
FROPER,TY DAMAGE
HIRED AUTOS ONLY �,9CUTHOD
NOTN-OWONNED (Per LY Acado.
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $2,000,000
A EXCESS LIAR CLAIMS-MADE N N 1902754 08/0512026 08/05/2027 AGGREGATE $2,000,000
DED RETENTI.
ANY PROPRIETORIPARTNERI EXECUTIVE PER STATUTE THER _
OFFICERtMEMBER EXCLUDED? YIN E.L EACH ACCIDENT
(Mandatory in NH) ..—. .—...— ..--... ..—..-- ..—..'
If yes,describe under N/A E.L DISEASE EA EMPLOYEE
DESCRIPTION OF OPERATIONS below
E.L DISEASE POLICY LIMIT
DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES(ACORD 101,Additional RemarBs Schedule,may be attached if more space is required)
CERTIFICATE HOUR CANCELLATION
CITY OF ASHLAND 9 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
20 E MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ASHLAND,OR 97520-1814
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
tc� 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD