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HomeMy WebLinkAboutInsurance Certificate: Cut N Break Construction _ CITY RECORDER A °RO® 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 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 endorsements . PRODUCER COCONTACT NE_ Sasd Wilson, AAI, A.IC Beecher Carlson- Insurance Agency LLC PHONE '541)772-1111 NC NO: 15417992-3785 .san.wilson@beechercarlson.com 3256 Hillcrest Park Drive su INSURE 3 AFFORDING COVERAGE NAIC Medford OR 97504 INSURERAAZBr1Can Hallmark Ins Co of TX 3494 INSURED INSURERB:SAIT Corporation 2412 Cut N Braak Construction Inc INSLIRERC:irest:era curet a 3188 P O Box 1455 INSURERD: INS::RIRTER EE Medford OR 97501-0108 n : COVERAGES CERTIFICATE NUMBER:CL134426578 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 NMICH 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. IR TYPE OF INSURANCE ADM SUBR POLICY NUMBER MMIICYEFF (MMIDDNYYY) UNITS LT R GENERAL LIABILITY EACH OCCURRENCE r 1,000,000 X COMMERCIAL GENERAL L ABILITY PREMISES Ee ormnence $ 100,000 A CLAIMS-MADE EOOCCUR X 4CL44930206 /1312013 /1312014 MEO EXP(Any one permn) S 5,000 PERSONAL 4 ADV INJURY 1 1,000,000 GENERn AGGREGATE r 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO 1 2,000,000 X POLICY PRO- LOC r AUTOMOBILE LIABILITY LE LIMIT 1,000,000 A X ANY ALTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED 4CL44930206 /13/2013 113/2014 BODILY INJURY (Per eaiderM) $ AUTOS NONTOG -OWNED PROPERTY DAMAGE r HIREDAUTOS AUTOS Perecdd.nf Mediml InnYrne-Is $ $ 000 UNSRELLA LUIS OCCUR EACH OCCURRENCE $ EXCESSUAB CIA,MS-M DE AGGREGATE $ [TED RE-rMTnurv y II B WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS' LABILITY ANY PROPRIETORIPARTWRIEECUTIVE[ NIA E.L. EACH ACCIDENT $ 500 000 OFFICERIMEMBER EXCLUDED? 89003 0/1/2012 0/1/2013 (Mandatory In n NH) E.L. DISEASE - EA EMPLOYE S 500,000 If yes desmbe Imd , 0 DESCRIPTION OPOPERATIONS below E. L. 015EASE-POLICY LiMiT E 500,00 C BOLI Bond (Statutory) 0106243 /5/2012 /5/2013 Limit $30,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atach ACORD 101, AdditWnM Remarlu Sch4dWa, If more apace Is roquln M Verification of insurance. Subject to policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION (S41)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. 90 N Mountain Avenue Ashland, OR 97520 AUTHORIZED REPRESENTATIVE S Wilson, AAI, AIC/SU • /'t/ ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005)01 The ACORD name and logo are registered marks of ACORD