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HomeMy WebLinkAboutInsurance Certificate: Keller Associates KELLE-0 OP ID: SW ,acoRO° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) ��. 04/26/12 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). CONACT PRODUCER - `� 208-459-1678 NAME: The Hartwell Corporation-Cal-': °' PHONE '" FAX PO Box 400' -` ^ • 20854-1114 Jc No Etl:^ AIC No):? Caldwell,.ID 83606-.,r! 1 E-MAIL ADDRESS: • .. ...:.., James H.-Goodell-�- , -..__ ' INSURERS AFFORDING COVERAGE NAIL If INSURER A:Travelers Indemnity Co 25666, INSURED Keller Associates,Inc. - - INSURER B:Travelers Indemnity of CT 25682 131 SW 5th Avenue, Suite A INSURER C:Travelers Casualty and Surety 31194 Meridian, ID 83642 INSURER D:Travelers Casualty&Surety 31194 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. INSR TYpE OF INSURANCE AD DL UB POLICY NUMBER MM/DIYYVY PO"C YYYY LIMITS INSR LTR GENERAL LIABILITY EACH OCCURRENCE $ 1.000.00 A X COMMERCIAL GENERAL LIABILITY X 6807877L118 12101/11 12/01112 DAMA ET RENTED cc 1,000,00 PREMISES Ea ourrence $ CLAIMS-MADE [ A I OCCUR MED EXP(Any one person) $ 10,00 PERSONAL B ADVINJURY L$ . 1,000,00 GENERAL AGGREGATE 2,00000 GENE AGGREGATE LIMIT APPLIES PER'. 'PRODUCTS-COMP/OP AGG '_2,000,00 POLtCY. .X PRO- LOG - - _. -_ _ ._ . ..., i AUTOMOBILE LIABILITY -_` - ' - "COMBINED SINGLE LIMIT- - -" 1,000,00 _ _ ) 5.' .I. Ea accident) $ IBP.I.Xt ANYAUTO,,, X BA78771_466 ^12101111 12/01/12 BODILY INJURY(Per Peison)t: $-- - ",r ALL OWNED SCHEDULED .I. -._ - - -- - - -- - BODILY INJURY(Per accident) $ AUTOS AUTOS ... _. . _ .NON-OWNED;..: '_.,. v _- ___. - ._ _ __ - .PROPERTY DAMAGE . _ -- -_ '+ HIRED AUTOS. AUTOS Per accident) $ qy . $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY T R LIMIT ER C ANY PROPRIETORIPARTNERIEXECUTIVE Y UB9722YO81 05/01/12 05/01/13_ E.L.EACH ACCIDENT $ ,. 1,000,00 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) (WA STOP GAP) E.L.DISEASE-EA EMPLOYEE $ 1,00000 If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 1,000,00 D Profes Liability _ 105714124 - 12101111 12/01112 E 2,000,00 $100,000 Deduct Annl Aggr 2,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) The City of Ashland,Oregon, its elected officials,officers and employees are additional insureds for general liability and auto liability as provided by policy forms CGD381 and CAT353. tickaec CERTIFICATE HOLDER ANCELLATION APR 3 0 MLA ILU� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Ashland THE' EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY ACCORDANCE WITH THE POLICY PROVISIONS. 25 E Main Street Ashland, OR 97520 UTHORIZED REPRESENTATIVE `- 44 600a4A ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD