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HomeMy WebLinkAboutInsurance Certificate: FD Thomas Inc ® DATE (MM/DDIYYYY) ACCW" CERTIFICATE OF LIABILITY INSURANCE 9,222015 THIS RTIFICATE 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 NAMEACT Jessica Carpenter Woodruff-Sawyer Oregon, Inc. PHONE 03-416-7758 FAX Nc) 1001 SW 5th Avenue, Suite 1000 AI . AD aIL .jarpenter@wsandco.com Portland OR 97204 INSURER(S) AFFORDING COVERAGE NAIC # _ INSURERA:National Union Fire Ins Co Pittsbur 19445 INSURED FDTHOMA-01 INSURER B : _ F.D. Thomas, Inc. INSURERC: P O Box 4663 INSURER D : Medford OR 97501 INSURER E : _ INSURER F : COVERAGES CERTIFICATE NUMBER: 1096653439 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 ADDL SU_ I POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE 1 INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY I ! GL3372270 101112015 10/1/2016 EACH OCCURRENCE $1,000,000_ i--, DA A E TO RENTED _ !CLAIMS-MADE `XJ OCCUR PREMISES(Eaoccurrence $1,000,000_. LX Stop Gap $1M MEDEXP (Anyone person) $10,000 I ~ - PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE 52,000,0_00 PRO- I_7 POLICY JECT U LOC lPRODUCTS -COMP/OP AG $2,000,000 i~ l-- OTHER: _ $ A AUTOMOBILE LIABILITY CA3194404 10/1/2015 10/1/2016 COMBINED SINGLE LIMIT Eaaccident_ $1,000,00_0__ X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PR Po ERTY DAMAGE $ (Per accident) _ I X HIRED AUTOS ~X AUTOS $ UMBRELLA LIAB OCCUR~EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE [AGGREGATE _ $ DED RETENTION $ $ WORKERS COMPENSATION III STATUTEERH_ I AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE EEA ACCIDENT 1$ OFFICER/MEMBER EXCLUDED? N I p' (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE 5 If yes, describe under DESCRIPTION OF OPERATIONS below, E.L. DISEASE- POLICY LIMIT $ I ~ I ~ I DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Operations of the Named Insured subject to the terms, conditions and exclusions of the policy issued by the Insurance Company. All Operations 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 Service Center ACCORDANCE WITH THE POLICY PROVISIONS. 90 N. Mountain Ave. Ashland OR 97520 AUTHORIZED REPRESENTATIVE Cum I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD