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HomeMy WebLinkAboutInsurance Certificate: R&R Earthboring A~~ CERTIFICATE OF LIABILITY INSURANCE 7/1/2013 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 Andrea Pittman NAME: Beecher Carlson Insurance Agency LLC PRONE (541)485-6633 FAX Not .(541)485-3946 2911 Tennyson Ave. E-MAIL .andrea. pittmaa@beechercarlson.com Suite 304 INSURERS AFFORDING COVERAGE NAICN Eugene OR 97408 INSURERA:SAIF Corporation 52412 INSURED INSURER B : John Riggs, DBA: R&R Earthboring INSURER C: 85865 Hwy 99 S INSURER D: INSURER E $Ll ene OR 97405 INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 WC 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. INSR ADOL SUBR POLICY EFF POLICY E%P LTR TYPE OF INSURANCE POLICY NUMBER MM M LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMA E T RENTED COMMERCIAL GENERAL LIABILITY PREMISE Ea occurrence) $ CLAIMS-MADE F-IOCCUR MED EXP An one person $ PERSONAL d ADV INJURY $ GENERAL AGGREGATE $ GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC $ JFr'T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ A WORKERS COMPENSATION R WCSTATU- DTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE ❑ N/A E.L. EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) 624287 /1/2013 /1/2019 E.L. DISEASE - EA EMPLOYE $ 500,000 If Yes, descnbe under DESCRIPTION OF OPERAI IONS below E.L. DISEASE-POLICY.LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more space Is required) CERTIFICATE HOLDER CANCELLATION (541)552-2436 mcclarym@ashland.or.us 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. Mary McClary 90 North Mountain AUTHORIZED REPRESENTATIVE Ashland, OR 97520 M Godfrey, CIC/ANDRPI'' 9~ v ACORD 25 (2010105) ©1988.2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD