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HomeMy WebLinkAboutInsurance Certificate: Hydro Flow HYDRFLO.02 PHITE 4~~RO CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYY) - 7/10/2013_ 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 E 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(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 - ti` CONTACT - - I'1•- NAME. Medford Office PHONE FAX - c6, Insurance, Inc. (AIC, No,,Eat):(541) 779.1321 - (Alc, N;: (541) 779.9187 38 North Central Ave. E+^AIL Suite 100 ADDRESS: R Medford, OR 97501 INSURERS) AFFORDING COVERAGE NAICp INSURER A: North Pacific Insurance Co INSURED INSURER B : SAIF Hydro FIOW Inc. INSURER C: 1 PO Box 3849 INSURER D: Central Point, OR 97502 INSURER E 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 PER 6113-1 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. MI R I TYPE OF INSURANCE ADDLSUBR POLICY'EFF POLICY EXP INSRf MD POLICY NUMBER IMMIDDIYYfY)_ (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 A IX COMMERCIAL GENERAL LIABILITY C19175309 21312013 213/2014 DAMAGETORENTED-~ PREMISES(Eaoccuneltce) 5 100,000, CLAIMS-MADE I OCCUR MED E%P (Any one person) S 5,000 PERSONAL d ADV INJURY jS 1,000,000 GENERAL AGGREGATE S 2,000,0001 GEN L AGGREGATE LIMIT APPLIES PER Y 1. PRODUCTS - COMP/OP AGG S ..2,000,000 L':. u.. POLICY-~ ESiLOC - 1 15 • I AUTOMOBILE LIABILITY { - COMBINED SINGLE LIMIT 1 _ J~ _ (Ea acddent) 5 ,000,000 A I' . ANYAUTO C19175309 213/2013 2/3/2014 90DILYINJURY-Per person) 'S ']AUTOSS,: OWNED AUTOS SCHEDULED , d' BODILY INJURY (Per accident) S . _ NON OWNED i HIRED AUTOS - AUTOS PROPERTYDAMAGE ' - (PER ACCIDENTI $ I5 UMBRELLA LIAB X OCCUR EACH OCCURRENCE- I5 1,000,000 A I X EXCESS LIAR CLAIMS MADE 019175309 213/2013 2/312014 AGGREGATE 5 1,000,0001 t- DED X RETENTIONS 10,000 I S WORKERS COMPENSATION WC $TATU-I IOETH ANDEMPLOYERS'LIABILItt XTORYLIMIT$}~LR I CERIME - M EXCLUDED' ~ B ANY ETOR CUTNE YIN 768244 2/112013 2/1/2014 E.L. EACH ACCIDENT 5 500,000 1 NIA Mande RINIE (Mandatory In NH) EXCLUDED' NH) E L DISEASE- EA EMPLOYEE S 500,000 Cgs. describe under Cgs. OF OPERATIONS Beim E.L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAHach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN • 20 E. Main St ACCORDANCE WITH THE POLICY PROVISIONS. - Ashland, OR 97520 AUTHORIZED REPRESENTATIVE I of yat,.l ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD