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HomeMy WebLinkAboutInsurance Certificate: Beaver Tree Service (2) BEAVE-1 OP ID: DS (MM/DDYYYY) ,a►coRO CERTIFICATE OF LIABILITY INSURANCE 70625/2015 /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 Phone: 541-779-0177 NAME CT Insurance Marketplace, Inc. Fax: FAX 772-8235 PHONE FAX 1998 Skypark Dr Suite 100 vc No Ext : AC, No Medford, OR 97504 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Salf Corporation INSURED Beaver Tree Service, Inc. INSURER B: Clarence Wangle 270 Wilson Road INSURER C Central Point OR 97502 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 INSR SUWVD ER POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDYYYY MM/DDYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ LEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ JECT RO- LOC $ - POLICY P AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _ Ea accident $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS 'BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ f EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- 0TH TORY LIMITS ER AND EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 633691 07/01/2015 07/01/2016 E.L. EACH ACCIDENT $ 1,000,00 I OFFICER/MEMBER EXCLUDED. I (Mandatory in NH) ' N /A E.L. DISEASE EA EMPLOYEE $ 1,000,0001 If ye descn.be under DESCRIPTION OF OPERATIONS below EL . DISEASE POLICY LIMIT $ 1,000,00 i i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITYOFA 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 St Ashland, OR 86520 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights re 'served. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD