HomeMy WebLinkAboutInsurance Certificate: Mark & Patricia Seder
I
WILLIS-CLAY INS INC PR4~RE.11/UE~
202 SE 181STAVE 206 COMMERCIAL
PORTLAND, OR 97233
Policy number: 06368027-9
Underwritten by:
Artisan and Truckers Casualty Co
Insured: MARK A SEDER
CITY OF ASHLAND
20 E MAIN ST March 8, 2017
Policy Period: Apr 12, 2017 - Apr 12, 2018
ASHLAND, OR 97520
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland, OH 44101
1-800-444-4487
For customer service, 24 hours a day,
Name of Person or Organization 7 days a week
CITY OF ASHLAND
20 E MAIN ST
ASHLAND, OR 97520
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury Not applicable
Property Damage Not applicable
Combined Liability $1,500,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 06368027-9
Issued to (Name of Insured): MARK A SEDER
PATRICIA SEDER
Effective date of endorsement: 04/1212017 Policy expiration date: 0411212018
Form H98 (01104)
WILLIS-CLAY INS INC PRO9REUMF
202 SE 181ST AV E 206 COMMERCIAL
PORTLAND, OR 97233
Policy number: 06368027-9
Underwritten by:
Artisan and Truckers Casualty Co
Insured: MARK A SEDER
CITY OF ASHLAND March 8, 2017
20 ASHLAND, EHLAND, MAIN ST OR 97520 Policy Period: Apr 12, 2017 - Apr 12, 2018
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland, OH 44101
1-800-444-4487
For customer service, 24 hours a day,
Name of Person or Organization 7 days a week
CITY OF ASHLAND
20 E MAIN ST
ASHLAND, OR 97520
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury Not. applicable
Property Damage Not applicable
Combined Liability $1,500,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 06368027-9
Issued to (Name of Insured): MARK A SEDER
PATRICIA SEDER
Effective date of endorsement: 0411212017 Policy expiration date: 04112/2018
Form 1198 (01;04)