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HomeMy WebLinkAboutInsurance Certificate: Dry Creek Landfill LLC C l i ent#: 1137013 ROGUE WAS ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE (MM;ODIYYYY) 9/29/2015 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: Ifthe 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 NAME: Teresa Weston USI Northwest PHONE 541 685-5300 FAX A/C, No Ext : A/C, Not: 975 Oak Street, Suite 900 ADDR1ESS: teresa.weston@usi.biz Eugene, OR 97401 INSURER(S) AFFORDING COVERAGE NAIC# 541 685-5300 INSURERA: Greenwich Insurance Company 22322 INSURED INSURERS: XL Specialty Insurance Company 37885 Dry Creek Landfill, LLC INSURER C : One West Main Suite 401 INSURER D : Medford, OR 97501 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY RF 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. LTR TYPE OF INSURANCE NADD SRL WVD POLICY NUMBER MMIDDYNYYY MMrDDY/ LIMITS A X COMMERCIAL GENERAL LIABILITY GECO03582704 10/0112015 101011201 EACHOCCURRENCE $110001000 CLAIMS-MADE ~ OCCUR PREMISESO(Eaoccurrence) $100,000 X BIIPD Ded:1,000 MEDEXP(Any oneperson) $5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 JECT PRO PRODUCTS - COMP/OP AGG $ 2,000,000 7 LOC POLICY OTHER. $ A AUTOMOBILE LIABILITY AEGO03582404 1010112015 10101/201 E eccltleDlsINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY (Per person) ALL OWNED P SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTCS AUTOS Per accidentl B X UM13RELLALIAB OCCUR UE0003582504 10101/2015 1010112016 EACH OCCURRENCE $3000.0_00 EXCESS LIAR CLAIMS-MADE AGGREGATE s3,000,000 -T,-EDT X RETENTION S$1 O 000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY ANY PROPRI ETOR/PARTNER/EXECUT I'VE YIN EL EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E L. DISEASE - EA EMPLOYEE! $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached iI more space is required) City of Ashland its officers, agents and employees are added as additional insureds. CERTIFICATE HOLDER CANCELLATION CI of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520-0000 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S 163287321M 16328725 TRWJ R