HomeMy WebLinkAboutInsurance Certificate: Welburn Electric
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Oregon Workers' Compensation '4.wu
Certificate of Insurance sal
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 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
Welburn Electric Inc SAIF Corporation
PO Box 329 Sharon A Joy
Phoenix, OR 97535-0329 541.857.4209 shajoy@saif.com
Issued 10/10/2016 Limits of liability
Policy 488390 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
ELECTRICAL WORK AS REQUESTED AT VARIOUS SITES
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
) 6"
Kerry Barnett
President and CEO
400 High Street SL
Salem, OR 97312
P: 800.285.8525
F-
503.584.9812
Policy OLCA CertificateOflnsurance