HomeMy WebLinkAboutInsurance Certificate: Metal Masters Inc
~
~R .. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDOIYYYY)
OPID KIY I 10/06/09
METAL-1
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Protectors Insurance, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Pilot Rock Ins Agency LLC (CA) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 4669 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97501
Phone: 541-773-5358 Fax:541-772-1906 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A' Liberty North....est Insurance 41939
INSURER B: SAIF Corporation
Metal Masters lnc INSURER c:
3825 Crater Lake Hwy INSURER D:
Medford OR 97504
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM DR 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PArD CLAIMS
LTR NSR TYPE OF INSURANCE POLICY NUMBER 6fT'i!7~~fJ6~\ DATEiMM/DD~~ LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A X COMMERCIAL GENERAL LIABILITY C16150259 10/01/09 10/01/10 I PREMISES (Ea occurence) $100,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
- PERSONAL & ADV INJURY $ 1 ,000,000
- GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
Xl ,nPRO- n
X POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1, ODO, 000
A .!. ANY AUTO C16150259 10/01/09 10/01/10 (Ea accident)
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
{Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
A !J OCCUR D CLAIMS MADE C16150259 10/01/09 10/01/10 AGGREGATE $1,000,000
$
=1 DEDUCTISlE $
RETENTION $ $
WORKERS COMPENSATION X ITOYR'iLIMITS I IvEFt
AND EMPLOYERS' LIABILITY YIN ,
B ANY PROPRIETORlPARTNERlEXECUT1VD 812256 10/01/09 10/01/10 E.L. EACH ACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED? -- --
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500,000
If yes, describe under : __-.::-~.=::l $ 500 000
SPECIAL PROVISIONS below ,------- -....- E.L. DISEASE - POLICY LIMIT
OTHER "DY~( -. ,~- " WI !~~ \\ \\\
",,':' ~-:-'1
! \- - -
- 1\1
DESCRIPTION OF OPERATIONS I LOCA TlONS 1 VEHIOL'ES"I EXCLOSIONS~DOED BY. ENDORSEMENT I SPECIAL PROVISIONS
'IJ U' UVI U""" l01
\ L ' I
CERTIFICATE HOLDER
CANCELLATION
City of Ashland
City Hall
Ashland OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlON
DATE THEREOF, THE ISSUING INSURER ~ENDEAVOR-TO'MAll.:~tO-n rDAYSWRITTEN
NOTICE TO THE CERTIFICATE HOLDER N~M~ +d.~~ t~FT~ ~u~~AjLu~M{ol~ Sbb'~L
III; ,__h ----ll[)I!
IMPOSE NO OBLIGATION OR LIABILITY OF ANY, KIND UPON THE INSURER,ITS AGENTS10R
REPRESENTATIVES. i I ~ \ I ^_ III I
AUTHORIZED REPRESENTATIV I!J U I v I 0 1l!dJ I
IN. Alri'ignts reserveCl. I
The ACORD name and logo are registered marks of ACORD . .
CITYASH
ACORD 25 (2009/01)