HomeMy WebLinkAboutGale Contractor Services
ACORDTM
DATE (MM/DD/VYYY)
06/14/2007
PRODUCER
Aon Risk Services, Inc. of Michigan
3000 Town Center
Suite 3000
Southfield MI 48075 USA
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
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PHONE- 866 283-7122 FAX- 847 953-5390
INSURERS AFFORDING COVERAGE
INSURED
Builder Services Group, Inc.
d/b/a Gale Contractor Services
2015 Lars way
Medford OR 97502 USA
INSURER A.
INSURER B
old Republic Ins Co
Travelers Property Cas Co of America
National union Fire Ins Co of Pittsburgh
INSURER C
INSURER D.
NAIC #
24147
25674
19445
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TIIE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO TIIE INSURED NAMED ABOVE FOR TIIE POUCY PERIOD INDICATED. NOTWITIISTANDING
ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTIIER DOCUMENT WITII RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, TIIE INSURANCE AFFORDED BY TIIE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL TIIE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POUCIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR DO'
LTR INS
TYPE OF INSURANCE
POLICY EFFECTIVE POLICY EXPIRATION
DA TE(MM\DDlYV) DA TE(MM\DDlYY)
06/30/07 06/30/08
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurence)
MED EXP (Anv one person
POLICY NUMBER
LIMITS
A
MWZY5552507
~ERAL LIABILITY
X COMMERCIAL GENERAL LlABD"ITY
CLAIMS MADE ~ OCCUR
GENERAL AGGREGATE
PERSONAL & ADV INJURY
GENL AGGREGATE LIMIT APPLIES PER
~ POLlCY 0 ~g~ D LOC
PRODUCTS - COMP/OP AGG
A
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
MWTB 18398
06/30/07
06/30/08
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
( Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
c
GARAGE LIABILITY
B ANY AUTO
EXCESS /UMBRELLA LIABILITY
~ OCCUR D CLAIMS MADE
AGGREGATE
AUTO ONLY - EA ACCIDENI
OTHER THAN
AUTO ONLY
EA ACC
AGG
BE9834985
06/30/07
06 30 08
EACH OCCURRENCE
DDEDUCTIBLE
EJRETENIION $10, 000
B
TC JUB1 D
Deductible - AOS
TC2HUB121D1274TIL07
Deductible - Minnesota
TRJUB 122D026ATIL07
Retro - AZ,HI,MA,OR,WI
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR I PARTNER I EXECUTIVE
OFFICERlMEMBER EXCLUDED?
If yes, describe under SPECIAL PROVISIONS
below
06/30/07
06/30/08
B
06/30/08
EL DlSEASE-EA EMPLOYEE
06/30/07
E.L DlSEASE-POLlCY LIMIT
B
TWXJUB122D0271TIL07
06/30/07
Retention
Statutory
OTHER
Excess WC
$2,000,000
$2,000,000
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$2,000,000
$5,000,000
$10,000,000
$5,000,000
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$2,000,000
DESCRIPTION OF OPERATIONS/LOCATlONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENI/SPECIAL PROVISIONS
Certificate holder is named as Additional Insured with respect to the products-completed operations of insured as
required by written contract.