HomeMy WebLinkAboutInsurance Certificate: Design Space Modular Buildings
City County Insurance Services CERTIFICATE OF COVERAGE Rev. 717105`
Agent This certificate is issued as a matter of information only and confers no rights upon the
Wilson Heirgood Associates certificate holder other than those provided in the coverage document. This certificate
2930 Chad Drive does not amend, extend or alter the coverage afforded by the coverage documents listed
herein.
Eugene, OR 97408-7382
Companies Affording Coverage
Named Member or Participant COMPANY A - City County Insurance Services (CIS)
City of Ashland COMPANY B - National Union Fire Insurance Company of Pitts, PA
20 East Main Street COMPANY C - RSUI Indemnity
Ashland, OR 97520
COVERAGES
This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement, term
or
condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is
subject
to all the terms, conditions and exclusions of such coverage documents.
CO Type of Coverage Certificate # Effective Expiration Limits
LT Date Date
A General Liability 07LASH 7/1/2007 7/1/2008 General Aggregate $3,000,000
X Commercial General Liability Each Occurrence $1,000,000
X Public Officials Liability
X Employment Practices
X Occurrence
A Auto Liability 07LASH 7/1/2007 7/1/2008 General Aggregate None
X Scheduled Autos Each Occurrence $1,000,000
X Hired Autos
X Non-Owned Autos
A Auto Physical Damage 07APDASH 7/1/2007 7/1/2008
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
A X Property 07PASH 7/1/2007 7/1/2008 Per Filed Values
A X Boiler and Machinery 07BASH 7/1/2007 7/1/2008 Per Filed Values
B Excess Crime
C Excess Earthquake
C Excess Flood
A Workers' Compensation
escription:
Per Lease Agreement No. 0100671, the City of Ashland Parks & Recreation is leasing a mobile/modular building to be located at
the City's Ice Rink on Winburn Way and Nutley, in Ashland, Oregon. This unit will be leased for a minimum period of four months
beginning on or about November 6, 2007.
ertificate Holder CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date
thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to mail
Design Space Modular Buildings such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the
29336 Airport Road issuer of this certificate.
Eugene, OR 97402
By: / LU.000- Date: Nov. 5, 2007