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HomeMy WebLinkAboutInsurance Certificate: Ashland Sanitary & Recycling Service CORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY) TM 08/31/2009 PRODUCER (503)692-1520 FAX (503)692-1299 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION KBI Insurance, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P .O. Box 888 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. - 30 S.W. Boones Ferry Rd. INSURERS AFFORDING COVERAGE Patin, OR 97062 , INSURED Ashland Sanitary & Recycling Service INSURER A: NORTH PACIFIC INSURANCE COMPANY Valley View Landfill, Inc. dba: Valley View INSURER B: SAIF CORPORATION Transfer Station INSURER C: 170 Oak St INSURER D: AS 1 and, OR 97520 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MWDDNY DATE MWDDNY GENERAL LIABILITY 03 170064 09/07/2009 09/07/2010 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 100 , 000 CLAIMS MADE C, OCCUR MED EXP (Any one person) $ 5 , 000 A PERSONAL & ADV INJURY $ i , 000 , 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 I F] POLICY PRO LOC JECT AUTOMOBILE LIABILITY 03 170064 09/07/2009 09/07/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS LIABILITY 03 170064 09/07/2009 09/07/2010 EACH OCCURRENCE $ 1,000,000 X OCCUR FICLAIh1S MADE AGGREGATE $ 1,000,000 A $ DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION AND 30859 07/01/2009 0710112010 TU-S OTH- TORY LIMIT ER B EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 500 , 000 E.L. DISEASE - EA EMPLOYEE, $ 500 , 000 E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS E: ASHLAND RECYCLING CENTER HE CITY OF ASHLAND IS ADDED AS ADDITIONAL INSURED PER FORM CG 32 61 10 05. CERTIFICATE HOLDER X ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAY TEN NOTICE TO THE CE ICATE HOLDER NAMED TO THE LEFT, CITY OF ASHLAND g BUT FAIL TO M IL SUCH NO IC SHA IMPOSE NO OBLIGATION OR LIABILITY 20 EAST MAIN STREET r OF ANY UP THE COM , I S GENTS OR REPRESENTATIVES. ASHLAND, OR 97520 AUTHORI. j4kTIV ACORD 25-S (7/97) ©ACORD CORPORATION 1988