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HomeMy WebLinkAboutInsurance Certificate: Pathway Enterprises (4) PATHENT-01 DLECING ACORV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) s/s/zola 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 endorsement(s). PRODUCER NACONTACT ME: Dena Leong Medford Office PHONE FAX PayneWest Insurance, Inc. NC No at): (541) 779-1321 ac No :(541) 779-9187 38 North Central Ave. EaoDRE-M,uLSS: dleong@paynewest.com Medford, OR 97501 INSURER(S) AFFORDING COVERAGE NAIC N INSURER A : Philadelphia Insurance Co INSURED INSURER B : Pathway Enterprises, Inc. INSURERC: 1600 Sky Park Dr. INSURER D: Medford, OR 97504 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 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 TYPE OF INSURANCE SUB POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS J= =D1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 CLAIMS-MADE Fx] OCCUR X PHPK1019706 05I11I2014 06I30/2014 PREMISES Ea occurrence) $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GEN'L AGGREGATE UMITAPPLIES PER. GENERAL AGGREGATE $ 3,000,00 X POLICY ❑ JECT LOC PRODUCTS - COMP/OP AGO $ 3,000,00 OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accident A X ANY AUTO PHPKID19706 05111/2014 06/30/2014 BODILY INJURY (Per person) $ A OWNED I I SCHEDULED BODILY INJURY (Per accident) $ AUTOS S AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE E 3,000,00 A X EXCESS DAB CLAIMS-MADE PHUB420624 05111/2014 06/30/2014 gGGREGATE $ 3,000,00 DED RETENTION $ $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? O NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE E If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, AddlUonal Remarks Schedule, may be anached if mom space Is required) Certificate holder Is additional insured per endorsement PI-GLD-HS (10/11) #627 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 Attn: Karl Olson ACCORDANCE WITH THE POLICY PROVISIONS. 90 N Mountain Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD