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HomeMy WebLinkAboutInsurance Certificate: Bleser Construction DENNJBL-01 KORNELLT °A1Y" CERTIFICATE OF LIABILITY INSURANCE 2/13/2013 13/2013 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: ASSurety NW, Inc. PHONE FAX 8931 SE Foster Rd., Suite 200 ac No Eat: (503) 777-3700 A/c No): Portland, OR 97266 - E-MAIL - ADDRESS: _ INSURER(S) AFFORDING COVERAGE NAIC0 - INSURER A: Nevada Capital Insurance Company INSURED INSURER B Dennis J. Bleser dba Bleser Construction INSURER C: 707 Stringer Gap Road INSURER D: Grants Pass, OR 97527 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. ILTR TYPE OF INSURANCE POUCY NUMBER MWDDYIYYYY MMR)D UP UNITS NYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,006 A X COMMERCIAL GENERAL LIABILITY 77NPP4003419 2/13/2013 2/1312614 PREMISES Es ocamarce $ 166,666 CLAIMS-MADE FXIOCCUR MED UP (Any one person) $ 6,000 PERSONALS ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,06 X POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) 41 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-0OWNED PR PERTY DAMAGE $ HIRED AUTOS AUTOS PER ACCIDENT) f UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DECO RETENTION$ $ WORKERS COMPENSATION WCSTATU- OTH- FIR I S1 AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE❑ N/A E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? IM (Mandatory In NH) E.L. DISEASE -EAEMPLOYE$ It 68S6 escntal undar _ DSRIPTION OF OPERATIONS Iml. E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONSI VEHICLES (Adach ACORD 101, Addi lonal Remarks Schedule, M mom space Is mqulmcl) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Ci East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. 20 Ashland, OR 97520 AUTHORRED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD