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HomeMy WebLinkAboutInsurance Certificate: Pape Machinery A CERTIFICATE OF LIABILITY INSURANCE DATE 112121112012 12012 YYYY) nD12 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 CONTACT MARSH USA INC. NAME: 111 SW COLUMBIA,STE.500 PHONE FAX (AIC.No EM: INC No), PORTLAND,OR 97201 EMAIL Attn:Liz Whiting 503-248-1204 ADDRESS: INSURERS AFFORDING COVERAGE NAICM 900B10-05-PCAS-1213 PM INSURER A:National Union Fire Insurance Company 19445 INSURED INSURER B:NIA WA PAPE'MACHINERY,INC. CIO THE PAPE'GROUP INSURERC:NIA NIA PO BOX 407 INSURER D: NIA NIA EUGENE,OR 97440 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-001998348-30 REVISION NUMBER:I 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. INSR TYPE OF INSURANCE ADDL SI18R POLICY NUMBER MM/POLICY EFF PMIppY� LIMITS INSRIMD LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY GL 4309787 0310112012 0310112013 DAMAGE TO RENTED $ 1 W g00 CLAIMS-MADE I-XI OCCUR M ED EXP(Any one person) S 25,800 X CONTRACTUAL LAB PERSONAL B ADV INJURY $ 1.000.000 X PER LOC AGG S2M GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X1 POLICY PRO LOG $ A AUTOMOBILE LIABILITY CA 3482083 0310112012 03101/2013 OMBINEDtSINGLE LIMIT $ 1000000 E.X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS Peraccident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIf1 IT ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mantlatory in NH) E.L.DISEASE EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS 1el. E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more apace is required) RE: THE CITY OF ASHLAND,OREGON,AND ITS ELECTED OFFICIALS,OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS WHEN REQUIRED BY WRITTEN AGREEMENT OR CONTRACT AS RESPECTS TO OPERATIONS OF THE NAMED INSURED, � C E� 0VC. CERTIFICATE HOLDER 1/AR CANCELLATION CITY OF ASHLAND 2 ZO7 Z I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 EAST MAIN STREET M THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ASHLAND,OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Elizabeth A.Whiting fi:.:e.AePA 4.W0%,A%+/ ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD