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HomeMy WebLinkAboutInsurance Certificate: American Leak Detection BOTER-1 OP ID: TY ,4coI20 CERTIFICATE OF LIABILITY INSURANCE o06sn7//2710Yzol4 a 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 . PRODUCER Phone: 440-333-9000 CONT:CT NAME Dawson Franchise Insurance Div Fax: "0-356-2126 PHONE FAX 1340 Depot Street MC Ho Eat , ac No : Cleveland, OH 44116.1799 E-MAIL Franchise Division ADDRESS: INSURERS AFFORDING COVERAGE NAIC p INSURERA:American Cas Co of Reading, PA 20427 INSURED Boterman's Inc. INSURERB:Amerlcan Fire 8: Casual Co. dba American Leak Detection INSURER C : Travelers 25658 2821 Bullock Road Medford, OR 97504 INSURER D: 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 rypE OF INSURANCE ADOL SUER POLICY NUMBER MM/DDr mfis. LTR IYYYY MM ODYIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 A X COMMERCIAL GENERAL LIABILITY 2084358897 0710112014 07/01/2015 PREMISES Ea occurrence $ 300,00 CLAIMS-MADE Fx-1OCCUR MED EXP (Any one person) $ 10,00 PERSONAL S ADV INJURY $ 2,000,00 GENERAL AGGREGATE $ 4,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,00 POLICY IRO- IFCT F-1 LOG $ AUTOMOBILE LU181LIry Ea acciden(SINGLE LIMIT $ 1,000,00 B X ANY AUTO - BAA1656124220 07/0112014 07101/2015 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI RETENTION $ $ WORKERS COMPENSATION WCSTATU- CH AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y 71 N/A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If Y describe under - DE SCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ C Professional Liab 105636058 07/01/201g0710112015 Misc Prof 500,00 Retention 10,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ARach ACORD 101, Additional Remarks Schedule, If more space Is requlred) Additional Insured: The City of Ashland, Oregon, and it's elected officials, officers and employees are additional insured only with respect to the contractor's services to be provided under contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION W7H DATE THE POLICY PROVISIONS. WILL BE DELIVERED IN City of Ashland ACCORDANCE 90 N. Mountain Avenue Ashland, OR 97520 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD