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HomeMy WebLinkAboutInsurance Certificate: FD Thomas Inc (2) AC RO o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD YYYY) 12/20/2013 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 endorsements . CONTACT I o PRODUCER NAME: Jessica Woodruff-Sawyer'Or=gon,Inc- PHONE" - aCNe 24 - 1001 _S.W 5thAvenue,.Swte 1000 E-MAIL - - . I ADDRESS: m"'-d`= - Portland OR-97204 INSURERS AFFORDING COVERAGE NAIC N INSURERA ZUriC American n r n Company 16535 INSURED FDTHOMA-01 INSURER B: F.D. Thomas, Inc. INSURER C: P O Box 4663 INSURER D : Medford OR 97501 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1256495871 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 rypE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR IN SR WD POLICY NUMBER MM/DDIYYVY MM/DDIYYYY A GENERAL LIABILITY LA373910208 12131/2013 01 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PR EMISES Ea occurrence) GIAIMSWADE a OCCUR MED EXP (Any one person) $10,000 - _x Stop Gap$1M - PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 'GEN'E AGGREGATE LIMIT APPLIES PEA: +t'" PRODUCTS - COMPIOP AGG $2,000,000 f .POLICY X- P JECT RO- ..LOC $ _ Ea .1NED SIN AUTOMOBILE LIABILITY GLA373910208 - 2131/2013 - 011/2014 Me IGHE LIMIT - 51,000,000 ANY AUTO - - BODILY INJURY (Per person) $ ALL OWNED SCHEDULED, t. _ BODILY INJURY (Per accident) $ AUTOS AUTOS X HIRED AUTOS X AOTOSWNED PROPERTY DAMAGE $ S UMBRELLA LWB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEC) RETENTION$ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS LIABILITY YIN LM ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION CF OPERATIONS below 6L. DISEASE -POLICY LRdIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Operations of the Named Insured subject to the terms, conditions and exclusions of the policy issued by the Insurance Company. All Operations CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland Service Center ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland OR 97520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD sI