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HomeMy WebLinkAboutInsurance Certificate: FD Thomas 1DATE2/2o/o12012IYYYY) ,ac RO v® CERTIFICATE OF LIABILITY INSURANCE 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 NAME: WKimberly Schleiger FAX oodruff-Sawyer Oregon, Inc. P ONE H Ex 4 tl,50316-7900 INC No-503 4 -1815 1001 SW 5th Avenue, Suite 1000 E-MAIL Portland OR 97204 ADDREss:kschlei er w n m INSURERS AFFORDING COVERAGE NAIC 0 INSURER A' INSURED FDTHOMA-01 INSURER B F.D. Thomas, Inc. INSURER C: P 0 Box 4663 Medford OR 97501 INSURER D: INSURER E INSURER F: _ COVERAGES CERTIFICATE NUMBER: 414727040 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 ADDL UBR POLICY EFF POLICY EXP LM IN SR WVD POLICY NUMBER (MMIDDIYYYYI~ MMIDDIYYYY LIMITS A GENERAL LIABILITY LA373910207 12131/2012 2/3112013 EACH OCCURRENCE $1,000,000 RED X COMMERCIAL GENERAL LIABILITY AMA E T PREMISES Ea occurtance $300,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $10,000 X Stop Gap$1M PERSONAL S ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ JECT A AUTOMOBILE LIABILITY GLA373910207 2131/2012 213112013 Ea acdtlent $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- ANDEMPLOYERS'LIABILITY YIN ANV PROPRIETOWPARTNER/EXECUTWE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarlu Schedule, If more apace Is required) Operations of the Named Insured subject to the terms, conditions and exclusions of the policy issued by the Insurance Company. Policies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non-payment of premium. All Operations CITY FRECORUSN CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland Service Center ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland OR 97520 AUTHORIZED REPRESENTATIVE K .b"* ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD