HomeMy WebLinkAboutInsurance Certificate: D&B Carpet LLC
CERTIFICATE OF INSURANCE The American Hardware Mutual Insurance Company
Issue Date 06/03/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
SOL TIS KEVIN 937 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO BOX 435
MINNEAPOLIS, MN 55440-0435
INSURED COMPANIES AFFORDING COVERAGE
D & B CARPET, LLC A. American Hardware Mutual Insurance Company
LARSON'S FLOORING & MORE B
213 SOUTH FIR STREET c.
MEDFORD, OR 97501 ACCOUNT NO,: 1159003
COVERAGES:
THIS 1$ TO CERTIFY THAT 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 TERMS,
CO TYPE OF INSURANCE POLICY NUMBER EFF EXP LIMITS
DATE DATE
A GENERAL LIABILITY 2355145 07/21/09 07/21/10 GENERAL AGGREGATE $ 2,000,000
I ] COMMERCIAL GENERAL LIABILITY -- - . PRODUCTS ._COMP/QP AGG $ 1,000,000
I ] CLAIMS MADE [Xl OCCURRENCE PERSONAL & ADVERTISING INJURY $ 1,000,000
{ ] OWNERS & CONTRACTORS PROT. EACH OCCURRENCE $ 1,000,000
(X) BUSINESSOWNERS FIRE DAMAGE $ 250,000
MEDICAL EXPENSE (Anyone person) $ 5,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
I ) ANY AUTO
{ ] ALL OWNED AUTO BODilY INJURY (Per person) $
I ] SCHEDULED AUTOS
[ ] HIRED AUTOS BQDIL Y INJURY (Per accident) $
[ ) NON-OWNED AUTOS PROPERTY DAMAGE $
[ ] GARAGE LIABILITY COMBINED SINGLE LIMIT-EACH ACC. $
[ ] GARAGE LIABILITY OTHER THAN AUTO AGGREGATE $
[ ] GARAGE KEEPERS GARAGE KEEPERS LIMIT $
EXCESS LIABILITY EACH OCCURENCE $
[ ) UMBRELLA FORM AGGREGATE $
[ ] OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION & STATUTORY LIMITS
EMPLOYERS LIABILITY EACH ACCIDENT $
..' DISEASE" POLICY LIMIT $
DISEASE" EACH EMPLOYEE $
OTHER
..-.". -. - --- --- -- . - -
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES RESTRICTIONS/SPEC1ALITEMS:
CERTIFICATE HOLDER CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY
CITY OF ASHLAND WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
NAMED TO THE LEFT, BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO
PUBLIC WORKS OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
90 NO. MOUNTAIN AVE REPRESENTATIVES.
.
ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE
~
511-7411 (1-02)