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Home My WebLink AboutInsurance Certificate: Mountain View Paving SAIF Corporation 2/12/2014 10:42:13 AM PAGE 1/001 Fax Server C9Y ROCOR Li I Ww .Wf,eom OREGON WORKERS COMPENSATION 4- Ph saiF CERTIFICATE OF INSURANCE Jcorporation CERTIFICATE HOLDER: CITY OF ASHLAND PURCHASING - ATTN SHERRIE 90 N MOUNTAIN AVE ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. POLICY NO. POLICY PERIOD ISSUE DATE 496578 10/01/2013 to 10/01/2014 02/12/2014 INSURED: BROKER OF RECORD: MOUNTAIN VIEW PAVING INC WARD INSURANCE AGENCY INC PO BOX 508 PO BOX 10167 TALENT, OR 97540-0506 - EUGENE, OR 97440 LIMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Body Injury by Disease $500,000 policy limit DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: All operations performed by the named insured for the certificate holder in accordance with policy terms and conditions. IMPORTANT: The coverage described above is in effect as of the issue date of this certificate. It is subject to change at any time in the future. This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. This certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the certificate holder. CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE. AUTHORIZED REPRESENTATIVE John C. Plotkin President and CEO 400 High Street SE Salem, OR 97312 P: 800.285.8525 F: 503.373.8020 PoYCy_eatch_Cedifk te0nns ame