HomeMy WebLinkAboutInsurance Certificate: BC MTH LCC
CERTIFICATE OF LIABILITY INSURANCE
02/0412013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATON 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 certa Sate 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).
PROD Cpl DARYN FARMER INSURANCE AGENCY INC N MME -DARYN FARMER
PO BOX 4220 PHONE "
JIAIL
Statefarm BROOKINGS, OR 97415 ADaR,ESS:
URER(Ei AFFORnING COVnUGE
INSURER A: Slate Farm Fire and Casual~CcmQa~_ 15143
INSURED BC MTH LLC
INSURER B:
175 PIEDMONT OR INSURER C:
ASHLAND, OR 97520 NsuRERO:
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER: RE MN NUMBER:
THIS IS TO CERTIPY 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 VJITH 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 PROCLAIMS,
INSR
LTR TYPEOFINSURANCE POLICY NUMBER MMOU YEFF MLBD YE%p
GENERAL LMIBILRY LIMITS
❑Y 97-BP-K5684 0312912013 03/2912014 1 EACH OCCURRENCE S 2,000,000
X COMMERCIAL GENERALUABILITY
I PROEM ES EEO o~m,E .nc4 E
CLAIMS-MADE OCCUR MED EXP IAny pg parson! 3
PERSONAL E ADV INJURY : t
GENERAL AGGREGATE ~S 4,000,000
PE 'L AGGREGATE LIMIT APPLIES PER
-PRO. I PRODUCTS-COMPIOP AGO $ 4,000,000
POLICY LOC _
AUTONOBILE LIABILITY ❑I IN
M IN 1!
Ea acti0anl ~ S
ANY AUTO BODILY INJURY (Per panool
ALL OWNED SCHEDULED E
AUiO$AUTOS BODILY I JURY (ft,
ROGOenI
FARED AUTOS NON-OWMED J N I;3
AUTOS Per6P-OnMA2,`E-._-. E
UNaREl1A l1A9 OCCUR
CF$B LIAR EACH OCCURRENCE E_
CWMS-M_AO_Ei tl! r~ t tliri•Y'"'?ti Ir I+L
EA })k! ( I IC U( .,i; AGGREGATE S
DED RETENTIONS
MWERSCOMPENSATN)N 51 ~1'(y/' I I't S3rE^~- sl, 3
ANDEMPLOYERSUAIIII F"'* V~1 x.~- 'Y t1 NC STATI} OTM-
MyPROPRIETORNARTNER/EOIECUTIJE YIN ( f '(v y A, A L rl. 4 T Y T
jF~ERAEMBER EXClU0E0T O NIAY tt C ,r A 1 I E.L. EACH ACCIDENT 3
II Yea, mamM umer -E L. DISEASE EA EMPLOYE 3
E.L DISEASE~OLICY LIMIT $
C
DESCRIPTION OF OPERATIONS F LOCATIONS F VEHICLES I
I
vl 1
CERTIFICATE HOLDER CANCELLATION
THE CITY OF ASHLAND AND THE ASHLAND PARKS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TION
ATE
THEREOF, AND RECREATION COMMISION, THEIR OFFICERS, A CORD EXPIRAE WITH DINE POL CV PROV19 01E5 E Vy1LL BE DELIVERED IN
EMPLOYEES, AND AGENTS
20 E MAIN ST ASHLAND, OR 97520 AUTHORNEDREPRESENTATNE
®198&2010 C RD COR ORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are Iegistered marks of ACORD
7007486 132849.8 01-23-2013