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HomeMy WebLinkAboutInsurance Cancelation: Visar Construction dba Sesar Homes /2NO3.2 41 1 CERTIFICATE OF LIABILITY INSURANCE 10/1 0/3.0/2012 I`/ 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 endorsements . PRODUCER CONTACT NAME: Pam Breazeale Beecher Carlson Insurance Agency LLC PNONE . (541)494-2655 FAX .(541)494-2755 707 Murphy Rd E-t'taL . pam. breaz ealeLbeIS cher ar1E;n com INSURERS AFFORDING VERAGE NAIC 0 Medford OR 97504 INSURERA WeSt American surance Co 4393 INSURED INSURER B : Visar Construction Co, Inc., DBA: Sesar Homes, INSURERC: PO BOX 3101 INSURER D: INSURER E Central Point OR 97502 INSURER F: COVERAGES CERTIFICATE NUMBER: 12-13 GL BA REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CON CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE OLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN R CED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY NUMBER MMIDD POUCEFF Y POLICY EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMA X COMMERCIAL GENERAL LIABILITY PREMIS GE To ES Ea set $ 11000,000 A CLAIMS-MADE OCCUR X RW54931 7 10/26/201210/26/2013 MED EXP An one person $ 15,000 PERSONAL &ADV INJURY $ 11000,000 A GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY PRO LOC / $ AUTOMOBILE LIABILITY ` COMBINED SINGLE LIMIT (IN Es accident 11000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED AW54 31972 1 /26/2012 10/26/2013 AUTOS X AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NOON-OWNED PROP RTY DAMAGE $ AUTOS r Underinsured motorist $ 11000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION 01 STATUS DTH- ANDEMPLOYERS-LIABILITY YIN ANY PROPRIETOR/PARTNENEXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERA^ONS LaIOm E.L. DISEASE - POLICY UMIr $ DESCRIPTION OF OPERATIONS I ATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space is restulred) General Liability olicy includes Blanket Additional Insured coverage as required by written contract per form p CGS811 ( /09). This form is s ]ect to policy terms, conditions, and exclusions. CERTIFICATE HOLDER LI CANCELLATION (541) 488- 6006 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland ~n 20 East MaSt V - U 2012 Ashland, OR 97 0 AUTHORIZED REPRESENTATNE n Pam Breazeale/PAMBRB 9a, /rA ACORD 25 (2010/05) © 1966-2010 ACORD CORPORATION. All rights reserved. I NS025 (201005).01 The ACORD name and logo are registered marks of ACORD