HomeMy WebLinkAboutInsurance Certificate: Design Space Modular Buildings
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_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
DIRECT certificate holder other than those provided in the coverage document. This certificate
does not amend, extend or alter the coverage afforded by the coverage documents listed
herein.
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 10LASH 7/1/2010 7/1/2011 General Aggregate $15,000,000
X Commercial General Liability Each Occurrence $5,000,000
X Public Officials Liability
X Employment Practices
X Occurrence
A Auto Liability 10LASH 7/1/2010 7/1/2011 General Aggregate None
X Scheduled Autos Each Occurrence $5,000,000
X Hired Autos
X Non-Owned Autos
A Auto Physical Damage 10APDASH 7/1/2010 7/1/2011
X Scheduled Autos
X Hired Autos
X Non-Owned Autos
A X Property 10PASH 7/1/2010 7/1/2011 Per Filed Values
A X Boiler and Machinery 10BASH 7/1/2010 7/1/2011 Per Filed Values
B X Excess Crime 10CASH 7/1/2010 7/1/2011 Per Loss $250,000
C Excess Earthquake
C Excess Flood
A Workers' Compensation
escription: Per Lease Agreement No. 0101082, the City of Ashland Parks & Recreation is leasing a 10x32 mobile office unit 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 of four months
beginning on or about November 2, 2010.
Certificate 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: Date: October 19, 2010