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HomeMy WebLinkAboutAddl Insurance Endorsement: Seder, Mark & Patricia I WILLIS-CLAY INS INC PRLURFUMAE1 202 SE 181ST AVE 206 COMML-RC/AL PORTLAND, OR 97233 Policy number: 06368027-8 Underwritten by: Artisan and Truckers Casualty Co Insured: MARK A SEDER CITY OF ASHLAND August 4, 2016 20 E MAIN ST Policy Period: Apr 12, 2016 - Apr 12, 2017 ASHLAND, OR 97520 Mailing Address Artisan and Truckers Casualty Co PO Box 94739 Additional insured endorsement Cleveland, OH 44101 1-800-444-4487 For customer service, 24 hours a day, Name of Person or Organization 7 days a week CITY OF ASHLAND 20 E MAIN ST ASHLAND, OR 97520 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. Limit of Liability Bodily injury Not applicable Property Damage Not applicable Combined Liability $1,500,000 each accident All other terms, limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number: 06368027-8 Issued to (Name of Insured): MARK A SEDER PATRICIA SEDER Effective date of endorsement: 08/03/2016 Policy expiration date: 04/1212017 Form 1 198 (01/04) WILLIS-CLAY INS INC PR!l4GREIRYAF 202 SE 181STAVE 206 COMMERCIAL PORTLAND, OR 97233 Policy number: 06368027-8 Underwritten by: Artisan and Truckers Casualty Co Insured: MARK A SEDER CITY OF ASHLAND August 4, 2016 20 E MAIN ST Policy Period: Apr 12, 2016 - Apr 12, 2017 ASHLAND, OR 97520 Mailing Address Artisan and Truckers Casualty Co PO Box 94739 Additional insured endorsement Cleveland, OH 44101 1-800-444-4487 For customer service, 24 hours a day, Name of Person or Organization 7 days a week CITY OF ASHLAND 20 E MAIN ST ASHLAND, OR 97520 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. Limit of Liability Bodily Injury Not applicable Property Damage Not applicable Combined Liability $1,500,000 each accident All other terms, limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number: 06368027-8 Issued to (Name of Insured): MARK A SEDER PATRICIA SEDER Effective date of endorsement: 08/03/2016 Policy expiration date: 04/1212017 Form 1 198 (01104)