HomeMy WebLinkAboutInsurance Certificate: Keller Associates (5)
`°RO' CERTIFICATE OF LIABILITY INSURANCE DA7IMMDD""`"
05/21/13
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. H 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 208459-167 NCOWACT
AME:
The Hartwell Corporation - Cal 208454-111 pHC No Ect: FAX No:
PO Box 400
Caldwell, ID 83606 AE-MAL
DDRESS:
Jeremy Kroll INSURERS AFFORDING COVERAGE NAIC a
INSURERA:Travelers Indemnity Co of Am. 25658
INSURED Keller Associates, Inc. INSURER e: Travelers Indemnity of CT 25682
131 SW 5th Avenue, Suite A INSURER C: Travelers Casual and Sure 31194
Meridian, ID 83642
INSURERD:Travelers Indemnity Co 25666
INSURER E: XL Specialty Insurance Co. 37885
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.
TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
Q X COMMERCIAL GENERAL LABILITY X 68076771.118 12101/12 12/01113 PREMISES Ea occweme $ 1,000,00
CLAIM MADE Q OCCUR NED EXP (Any one Person) $ 10,00
X CGD381 PERSONAL 8 ADV INJURY $ 1,000,00
X CGD379 GENERAL AGGREGATE $ 2,000,00
GENL AGGREGATE LIMITAPPLIEB PER'. PRODUCTS - COMP/OP AGG $ 2,000,00
POLICY X PR0. L"
$
AUTOMOBILE LIABILITY Eeaccidenl 1,000,0o
B X My AUTO X BA7877L468 12101/12 12/01113 BODILY INJURY( Per parson) $
ALL OWNED SCHEDULED BODILY INJURY (Per acoden0 $
AUTOS NOAUTOS
N-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS
X CAT353 $
UMBRELLAUAS X OCCUR EACH OCCURRENCE $ 4,000,00
D EXCESS LIAR CLAIMS-MACE CUPB961X179 12101/12 12/01113 AGGREGATE $ 4,000,00
DED X RET ION 10000
WORKERS COMPENSATION X WC STAN- OTRH-
AND EMPLOYERS' LIABILRY
C ANY PROPRIETORIPARTNEREXECUnvE Y® U89722YO81 05101113 05101/14 E. L. EACH ACCIDENT $ 1,000,00
OFFICERIMEMBER EXCLUDE09 NIA
IMimdaI in NHl W0000313 EL. DISEASE - EA EMPLOYE $ 1,000,00
DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 1,000,00
D Profes Liability DPR97D4373 12/01112 12/01113 Ea. Claim 2,000,00
5100,000 Deduct - - - Annl Aggr - -4,000,00 -
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aeach ACORD 101, Additional Rema*s Schedule, amore space is required)
ASHAS-2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
20 Ease Main St.
Ashland, OR 97520 AUTHORIZED REPRESENTATIVE
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