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HomeMy WebLinkAboutInsurance Certificate: Bergeson-Boese & Associates A& CERTIFICATE OF LIABILITY INSURANCE 4/DAM 29/20D13YI 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 CONTACT Kris Sutherland NAME: Ward Insurance Agency PHONE (541) 687-1.117 FAX (541)342-8280 AIC No: PO Box 10167 .kris@wardinsurance. net INSURERS AFFORDING COVERAGE NAIC f Eugene OR 97440 INSURERAAdnlrel Insurance Co an INSURED INSURERB:Nationwide Mutual Ins Company 3787 Bergeson-Boese & Associates Ina INSURERC: DBA BB&A Environmental INSURER D: 32986 Roberts Court INSURER E: Coburg OR 97408 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/AU/UM/POLL/PROF 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 ADM SWR POLICY NUMBER MMIDDIYYEFF Y MMIDDYEXP LIMITS GENERAL LIASILW( EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) Y 50,000 A CLAIMSJAADE FE OCCUR EIECC14791-00 /30/2013 /30/2014 RED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY X P~ LOC Y 1-1 AUTOMOBILE LMBILT`Y COMBINED SINGLE LIMIT B X MY AUTO BODILY INJURY (Per person) $ ALL OMED SCHEDULED P7581541172 /30/2013 /30/2014 AUTOS AUTOS BODILY INJURY (Par eaitlen[) $ X HIREDNJTOS X AUTOS ED PROPERTY acatlent) $ Unnsmed motonst combined $ 1 000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTIONS EIEXS14792-00 /30/2013 /30/2014 S WORRERSCOMPENSATION NC STATLL OTH- AND EMPLOYERS' LIABILITY YIN TORY LIMITS FIR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E. L. DISEASE-EA EMPLOYE $ Ifes tlescdbe antler DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ A POLLUTION LIABILITY EIEXS14792-00 /30/2013 /30/2014 LIMIT 1,000,000 PROFESSIONAL LIABILITY LIMB' 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES III ACORD 101, Additional Remarks Schedule, if more space is required) THE CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE ADDED AS ADDITIONAL INSUREDS IF REQUIRED BY WRITTEN CONTRACT CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2 0 ~n 2 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ID l` JJ VC v CSC ACCORDANCE WITH THE POLICY PROVISIONS. 20 E MAIN STREET ASHLAND, OR 97$2 UTMORIZED REPRESEMATIVE MAY 2 2013 LI Harvey/CARSON :.;z..•:_ ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. I NS025 (201005) 01 registered marks of ACORD