HomeMy WebLinkAboutInsurance Certificate: Dean Shutt
AOM
INSURANCE SERVICES
CERTIFICATE of INSURANCE
This certificate is issued to
City of Ashland, OR
20 E. Main St.
Ashland, OR 97520
On behalf of Named Insured Dean Shutt
Po Box 170
Williams, OR 97544
Insurer Old Republic Aerospace, Inc.
Issuing Insurer Policy No. PB11768204
Policy Period January 27, 2017 to January 27, 2018
Insured Aircraft Coverage Limits of Liability
1996 MOONEY M20J, N9131N Single Limit Bodily Injury & $1,000,000 each occurrence limited to $100,000 per passenger
Serial No.: 24-3397 Property Damage Liability
Aircraft Physical Damage $180,000 insured value
Ground and Flight
Deductibles: $0 in motion $0 not in motion
Additional Coverages or Agreements
1. The Certificate Holder is included as an Additional Insured with respect to operations of the Named Insured.
This certificate is issued for information purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It
does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does
not change the terms, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or
conditions, regardless of the provisions of any other contract, such as between the Certificate Holder and the Named Insured. Notice is hereby given
that AOPA Insurance Services is not the Insurer hereunder and shall not be held liable for any loss or damage. Should any of the above described
policies be cancelled before the expiration date thereof, the Issuing Insurer will endeavor to provide thirty (30) days advance notice to the Certificate
Holder, but failure to do so shall impose no obligation or liability of any kind upon the Insurer, its agents or representatives.
Date of Issue: February 22, 2017 g'' i
Authorized Representative:
AOPA INSURANCE SERVICES
CERT AL-AL-C01-0 OFFICE 1995 MIDFIELD ROAD WICHITA, KS 67209
JM MAIL P.O. BOX 9170 WICHITA, KS 67277
P 800-622 AOPA[2672] F 316 942 0091
aopainsurance.org
CONFIDENTIAL
OCERT-AL-AL-COI-O 2016-10-385763 42831