HomeMy WebLinkAboutInsurance Certificate: Patton Enironmental 26/2013 10:02 AM From Ashland Insurance Inc / 541-488-5851 To: 15414885320 2 of
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CERTIFICATE OF LIABILITY INSURANCE 3/26/20 3/2 61200
13
O'YYY
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 pollcy(les) 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 NAME: T Julie Asher
Ashland Insurance Inc PnONE (541)482-0831 a (salt 4ee-5051
_IL 585 A Street Suite 1 p .jas is iB shlandinsurance. cam
P. O. BOX BBO INSURERS AFFORDING COVERAGE NAICd
Ashland OR 97520 INSURER A Mutual of Enumclaw 4761
INSURED INSURER B:viCtOr O. Schinnerer
PATTON ENVIRONMENTAL LLC INSURER C:
9' HILLCREST ST INSURER D:
INSURER E:
ASHLAND OR 97520 INSURER P:
COVERAGES CERTIFICATE NUMBER:CL1332604071 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,
LTR TYPE OF INSURANCE A OD 5IJBR POLICY NUMBER MMIOOTIYVW MMIDOIYYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE 3 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea arraaroeae 5 300 r 000
A CLA0A5-MADE OCCUR X PPOO12667 2/10/2012 2/10/2013 MED EXP(Am one pwsc) 5 - 10,000
PERSONAL B ADV INJURY 3 1,000,000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG 5 2,000,000
X POLICY PRO LOC S
.JFCT
AUTOMOBILE LIABILITY Me arld.,J) NG IMR S
I U ANY AUTO BODILY INJURY (Per person) S
ALL OMEO SCHEDULED
AUTOS AW05 BODILY INJURY (PV eWdenq S
NON-OWNED PROPFATY DAMAGE S
HIRED AUTOS AUTOS PeraaNenl
5
UMBRELLA WAS OCcun EACH OCCURRENCE S
EXCESS LUIS CLAIMS-MADE AGGREGATE 5
DED RETENTIONS S
WORKERS COMPENSATION WC STATUS OTH-
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA El- EACH ACCIDENT 5
OFFICERIMEMSER FXCLUDEDT
(Mandalnry In NH) E.L DISEASE - EA EMPLOYE S
If yes, describe under
OESCRIPTIONOFOPERATIONSbclaw E.LOISEASE-POLICY LIMIT S
H Professional Liability EH288380654 2/7/2012 12/7/2015 Limit 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES IAUaoh ACORD 101, Additional RonerNz Schedule, If mold apaco In raqulrod)
City of Ashland is listed as an additional insured in regards to work performed by the insured for
General Liaiblity only
CERTIFICATE HOLDER CANCELLATION
(541) 488-5320. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
20 E. Main St. I T RECORDER
Ashland, OR 97520 L AUTHORIZED REPRESENTATIVE
ACORD 25 (2010/06) - 01988-2010 ACORD CORPORATION. All rights reserved.
INS025(20IDDS).Ol The ACORD name and logo are registered marks of ACORD
26/2013 10:02 AM From: Ashland Insurance Inc / 541-488-5851 To: 15414885320 1 of
Attached is the Cert of Insurance for Patton Environmental LLC
Julie Asher
Ashland Insurance Inc
PO Box 880
Ashland OR 97520
Phone (541)482-0831
Fax: (541)488-5851
e=mail: jasher@ashlandinsurance.com
Please remember that coverage cannot be bound, amended or cancelled via the voice mail or e-mail system. Coverage
cannot be assumed to be bound without written confirmation from an authorized representative of Ashland Insurance
Inc.
CONFIDENTIALITY NOTICE
The information contained in this communication, including attachments, may contain privileged and confidential information that
is intended only for the exclusive use of the addressee. If the reader of this message is not the intended recipient, or the employee
or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or
copying of this communication is strictly prohibited. If you have received this communication in error, please notify us by telephone
immediately