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HomeMy WebLinkAboutInsurance Certificate: Rogue Biofuels '4ki °O® CERTIFICATE OF LIABILITY INSURANCE 5/132014 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 CONTACT Kim Haas NAME: Elliott Powell Baden and Baker Inc. PHONE (503)227-1771 FA)( Not- 1521 S.W. Salmon Street E-MAIL .khaaBWepbb.com INSURER(S) AFFORDING COVERAGE NAICa Portland OR 97205-1783 INSURERA:Arch Insurance Co. INSURED INSURER B:SAIP 6196 Rogue Biofuels Corp INSURER C: PO BOX 3422 INSURER D: INSURER E Central Point OR 97502 INSURER F: 'COVERAGES - -CERTIFICATE NUMBER: 14-15 CiL,Auto & Work Comp 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. INS TYPE OF INSURANCE ADOL SUBR POLICY EFF POLICY UP ILTR POLICY NUMBER MM WrYYYY) LIMBS JIM Jm GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 TO ELATE X COMMERCIAL GENERAL LIABILITY REMI SES (Ea o ccurnmcel $ 100,000 A CLAIMS-MADE FxIOCCUR BCAT0173003 /12/2014 /12/2015 MED UP(M one Person $ 5,000 PERSONAL& AOV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGO $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 11000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BCAT0173003 /12/2019 /12/2015 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-0WNED PROPERTY DAMAGE $ AUTOS (Per accidentl UMBRELLA DAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ B WORKERS COMPENSATION X W C S T A T d U DTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOIUPARTNERIEXECNTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ NIA (Mandatory In NH) 70406 /1/2014 /1/2015 E.L. DISEASE-EAEMPLOYE $ 1 000,000 If Yes: descrihe under DEy1';RIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000,00 D DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H mom space Is wired) 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 ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland, OR 97520 AUTHORIZED REPRESENTATIVE Rim Haas/LJ ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD