HomeMy WebLinkAboutInsurance Certificate: Rogue Valley Heating & A/C
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Oregon Workers' Compensation
samif
Certificate of Insurance corporation
Certificate holder:
CITY OF ASHLAND
ICO KAYLEA KATHOL
51 WINBURN WAY
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named belowfor 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
Rogue Valley Heating & A/C Co Ward Insurance Agency Inc
2820 Foothill Blvd Chris Christensen
Grants Pass, OR 97526-4126 541.687.1117 chris@wardinsurance.net
Issued 09/16/2016 Limits of liability
Policy 520190 Bodily Injury by Accident $1,000,000 each accident
Period 10/01/2016 to 10/01/2017 Bodily Injury by Disease $1,000,000 each employee
Body Injury by Disease $1,000,000 policy limit
Description of operations/locations/special items
All operations performed by the named insured for the certificate holder in accordance with the policy terms and
conditions.
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.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN
ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE
WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE.
Authorized representative
Kerry Barnett
President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812
Policy_OLCA_Certificate0flnsurance
SAIF Corporation 9/16/2016 11:39:33 AM PAGE 1/001 Fax Server
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Oregon Workers' Compensation -4. 00AP - saulf
Certificate of Insurance pvcorporab
Certificate holder:
CITY OF ASHLAND
ICO KAYLEA KATHOL
51 WINBURN WAY
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named belowfor 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
Rogue Valley Heating & A/C Co Ward Insurance Agency Inc
2820 Foothill Blvd Chris Christensen
Grants Pass, OR 97526-4126 541.687.1117 chris@wardinsurance.net
Issued 09/16/2016 Limits of liability
Policy 520190 Bodily Injury by Accident $1,000,000 each accident
Period 10/01/2016 to 10/01/2017 Bodily Injury by Disease $1,000,000 each employee
Body Injury by Disease $1,000,000 policy limit
Description of operations/locations/special items
Re: Service to City HVAC
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.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN
ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE
WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE.
Authorized representative
Kerry Barnett
President and CEO
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812
Policy_OLCA_CertificateOflnsurarce