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HomeMy WebLinkAboutInsurance Certificate: Kaylor Electric LLC 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 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 - NAME: Insurance Marketplace, Inc. Arc,NO,Ext: (Arc,Noy 1998 Skypark Dr Suite 100 ADDRESS: Medford OR 97504 CUSTOMERID#: KAYLO-1 Phone:541-779-0177 Fax:FAX 772-8235 INSURER(5)AFFORDING COVERAGE NAICR INSURED - INSURER A: Allied Insurance Group Ka for Electric, LLC INSURER B: Saif Corporation P.O. Box 639 Phoenix OR 97535 INSURER C: INSURER D: INSURER E INSURER.F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. - LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MWDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY ACP 7504536050 07/01/11 07/01/12 PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ $,QQQ X - PERSONAL B ADV INJURY $ 1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP ADS $ 2,000,000 POLICY PRO JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ l,000,000 (Ea accident) A X ANY AUTO ACP 7504536050 07/01/11 07/01/12 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS X HIRED AUTOS PROPERTY DAMAGE $ (Per accident) X NON-0WNED AUTOS $ UMBRELLA LIAB OCCUR _ EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ 1 1 1 $ B WORKERS COMPENSATION 448917 04/01/11 04/01/12 W AT - - AND EMPLOYERS'LIABILITY YIN - TORY LIMIT S ER ANY PROPRIETORLPARTNERIEXECUTN E.L.EACH ACCIDENT $ SQ QQQQ OFFICERIMEMBER EXCLUOED4 IA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500000 If yes,describe under -DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,H mores ac�'i-reyB trod])f°/'�qf�DER Certificate holder is additional insured t$f ! (7CIV-;"'IVVV' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYJAC THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland Kerry AUTHORIZED REPRESENTATIVE 20 E. Main Ashland OR 97520 R. Scott Weaver, CIC ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD