HomeMy WebLinkAboutInsurance Certificate: Welburn Electric Inc
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Oregon Workers' Compensation sai F
corporation
Certificate of Insurance iro,'000111,
Certificate holder:
CITY OF ASHLAND
20 E. MAIN STREET
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named belowfor the policy period
indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of
such policy; this policy is subject to change or cancellation at any time.
Insured Producer/contact
Welburn Electric Inc SAIF Corporation
PO Box 329 Phil L Swinford
Phoenix, Or 97535-0329 541.672.4422 phiswi@saif.com
Issued 10/1612014 Limits of liability
Policy 488390 Bodily Injury by Accident $500,000 each accident
Period 10/01/2014 to 10/01/2015 Bodily Injury by Disease $500,000 each employee
Body Injury by Disease $500,000 policy limit
Description of operations/locations/special items
Important
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.
Authorized representative
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John D. Gilkey
Interim President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812
Policy_OLCA_Certif cateOflnsurance