HomeMy WebLinkAboutInsurance Certificate: Francis Dean & Associates
ADDITIONAL INSURED Date
1/21/2010
AGENCY PHONE 800-745-2409 APPLICANT First Named Insured Phone
(NC, No, Ext): (AX, No, Ext).
FAX
(NC, No,): 630-665-7294 Ashland Ice Hockey In The Park 2010
FRANCIS L. DEAN & ASSOCIATES, INC. 144 Sunnyview Drive
1776 S. NAPERVILLE RD., BLDG. B Ashland, OR 97520
P.O. BOX 4200
WHEATON, IL 60187
EFFECTIVE DATE EXPIRATION DATE CO/PLAN
CODE: SUBCODE: 1/22/2010 1/25/2010
AGENCY CUSTOMER ID POLICY NUMBER: P1GL-100000-02
ACCOUNT NUMBER:
INTEREST RANK. NAME AND ADDRESS REFERENCE CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER
X ADDITIONAL INSURED City of Ashland LOCATION BUILDING
LOSS PAYEE 20 East Main Street VEHICLE BOAT.
MORTGAGE Ashland, OR 97520 SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION:
INTEREST RANK. NAME AND ADDRESS REFERENCE # CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER
X ADDITIONAL INSURED Ashland Parks and Recreation Dept. and Ashland Parks Commission LOCATION BUILDING
LOSS PAYEE 340 S. Pioneer Street VEHICLE BOAT
MORTGAGE Ashland, OR 97520 SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION
INTEREST RANK NAME AND ADDRESS REFERENCE # CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER
X ADDITIONAL INSURED LOCATION BUILDING.
LOSS PAYEE VEHICLE BOAT
MORTGAGE SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION
INTEREST RANK. NAME AND ADDRESS REFERENCE CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER
X ADDITIONAL INSURED LOCATION BUILDING
LOSS PAYEE VEHICLE BOAT
MORTGAGE SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION
INTEREST RANK. NAME AND ADDRESS REFERENCE CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER
X ADDITIONAL INSURED LOCATION BUILDING
LOSS PAYEE VEHICLE: BOAT
MORTGAGE SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION:
INTEREST RANK NAME AND ADDRESS REFERENCE # CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER
X ADDITIONAL INSURED LOCATION. BUILDING.
LOSS PAYEE VEHICLE BOAT
MORTGAGE SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION.
INTEREST RANK NAME AND ADDRESS REFERENCE # CERTIFICATE REQUIRED INTEREST !N ITEM NUMBER
X ADDITIONAL INSURED LOCATION BUILDING
LOSS PAYEE VEHICLE BOAT
MORTGAGE SCHEDULED ITEM NUMBER:
LIENHOLDER OTHER
EMPLOYEE AS LESSOR
ITEM DESCRIPTION