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Oregon Workers' Compensation -4. Pto, samif
Certificate of Insurance corporation '00000 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 below for 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
Full Circle Real Estate LLC United Insurance Agencies
Full Circle Real Estate United Insurance Agencies
240 E Main St 541.242.6464 kellyc@uiaoregon.com
Ashland, OR 97520-1831
Issued 09/06/2016 Limits of liability
Policy 854801 Bodily Injury by Accident $500,000 each accident
Period 10/02/2015 to 10/01/2016 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
Kerry Barnett
President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9312
Policy_OLCA_CertificateOfInsui rice
www.saif.com
Oregon Workers' Compensation
salfâ–
Certificate of Insurance P,,OA corporation
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 below for 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
Full Circle Real Estate LLC United Insurance Agencies
Full Circle Real Estate United Insurance Agencies
240 E Main St 541.242.6464 kellyc@uiaoregon.com
Ashland, OR 97520-1831
Issued 09/06/2016 Limits of liability
Policy 854801 Bodily Injury by Accident $500,000 each accident
Period 10/01/2016 to 10/01/2017 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
) 6"', ~40c-
Kerry Barnett
President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812
Policy_OLCA_CertificateOfI nsurance