Loading...
HomeMy WebLinkAboutInsurance Certificate: Vitus Construction Inc (2) VITUS-1 OP ID: CB CERTIFICATE OF LIABILITY INSURANCE 0 D9101201YY) 09/05/2013 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 i 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 Phone: 503-224-2500 NACONCT ME Carol Bettin Anchor insurance 8: Surety Inc Fax: 503-224-9830 PHONE IFAX 1201 SW 12th Ave., Suite 500 A C No E ,-603-224-2500 C No : 503.224-9830 Portland, OR 97205-2030 AoDRESS: cbetdn@anchorias.com Brent Olson INSURER(S) AFFORDING COVERAGE NAIC0 INSURER A:SAIFCorporation 36196 INSURED Vitus Construction Inc. INSURER B: Corey Vitus INSURER C: PO Box 1097 Gold Hill, OR 97525 INSURER D: INSURER E : I 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. ILTR TYPE OF INSURANCE ADOLSUBB POLICY NUMBER (MM1DDffYYY1 MPOLICY EXP MIDD UNITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea oocunenoe $ CLAIMS-MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ OMP/OP AGO $ GEN'L AGGREGATE LIMIT APPLIES PER: ffl PRO LOC $ 17 POLICY ].IFCT F-1 AUTOMOBILE LIABILITY COMBINED L LIMA $ ANY AUTO (Per person) $ ALL OWNED SCHEDULED (Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED $ AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION X WCSTATU- ER AND EMPLOYERS' LIABILITY T [NITS A ANY PROPRIETORNARTNERIE)(ECUTNE YIN 811648 OREGON 1010112013 10/01/2014 E.L. EACH ACCIDENT $ 1,000,09 F-I OFFICERNEMBER EXCLUDED? NIA Islands" InNH) E.L. DISEASE - EA EMPLOYEE $ 1,000,09 If yes, dwwnbe under DESCRIPTION OF OPERATIONS W. E.L. DISEASE- POLICY LIMIT $ 1,900,09 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANaeh ACORD 101, Mmbonal Remarim ScMduls, I more space Is requlmd) 2013 Miscellaneous Concrete Project (2011-33) CERTIFICATE HOLDER CANCELLATION ASHLA-1 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. 20 EAST MAIN ST. ASHLAND, OR 97520 AUTHOR ZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD