HomeMy WebLinkAboutInsurance Certificate: Ashland Electric Inc
Nov.19. 2013 9:57AM FARMERS No-1297 P. 1/1
R~® CERTIFICATE OF LIABILITY INSURANCE °A1 no° 3""
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 INSURERIS), 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
cerliflcate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
Brian Gabaldon(7301363) PHONE - 541-734-2300 tFANC. Hal!
1381 Center Dr H 100 IL
INSURERS AFFORDING COVERAGE NAIL/
Medford OR 97501.7938 INSURER A: Truck Insurance Exchange 21709
INSURED INSURER B: Fanners Insurance Exchange 21652
ASHLAND ELECTRIC INC INsoRERc: Mid Century Insurance Company 21867
136 N LAUREL ST INSURER D :
INSURER E :
ASHLAND OR 97520 INSURER F:
COVERAGES CERTIFICATE NUMBERi 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
INDICATEO. 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 TYPEOFINSURANCE ADDL Bit POLICY NUMBER ~ICYEFF MMWOYYY LIMITS
GENERAL "NAVY EACH OCCURRENCE S 2,000,000
DAMA6ETORE1 ITEO
X250 D~
COMMERCIAL GENERAL LIABILITY PREMISES Ea emmenoe $
CLAIMS-MADE a OCCUR MEDO(P(Ayovewrs ) $ 6,000
C 605040512 09/1412013 09/1412014 PERSONAL aAovINJURY s 2,000,000
GENERALAGGREGATE S 4.000.000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COM%OP AGO S 4000000
POLICY PAO, LOC S
AUTOMOBILE LIABILITY ECOMBI~NED SINGLE LIMIT 2,000,000
ANY AUTO BODILY INJURY (Par Person) S
C AAUTO ED V AUTOS LEO 605040512 09114!2013 09/14/2014 BODILY INJURY (Per accident)
X HIRFp AUTOS X NON TO O ED PROPERTY DAMAGE i
3
I H UMBRELU LU1e OCCUR EACH OCCURRENCE S
EXCESS UAB CLAIMSMADE AGGREGATE i
DED RETENTION S
OM-
WORKERS COMPENSATION WCSTATU-
ANDHMPLOYERS'LIABILITY YIN
ANY PROPRIETORMARTHERJFAECVTIVE ❑ NIA El. EACH ACCIDENT $
OFFICEIUMEMSER EXCLUDED/
(Nando(oly In NH) E.L.OISEASE-EAEMPLOYE S
If yyos dewlbe under
DE8LHIPTIONOFOPERATI NSbobw E.L. DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES IAllech ACORD 101, AddlUonal RomaAe Schedule, Ifmae apace h required)
136 N LAUREL ST, ASHLAND, OR 97520
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 EAST MAIN ST ACCORDANCE WITH THE POLICY PROVISIONS.
ASHLAND OR 97520 AUTHOROP EPREeENT vE
ACORD 25 (2010/05) 01966-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD