HomeMy WebLinkAboutInsurance Certificate: Mark Seder (2)
WILLIS CLAY INS INC
202 SE 181ST AVE 206
PORTLAND, OR 97233 COMMERCIAL
MARK SEDER
ARCHITECTURE+URBAN DESIGN
MARK A SEDER Policy Number: 06368027-9
PATRICIA SEDER Underwritten by:
ARCHITECTURE+URBAN DESIGN Artisan and Truckers Casualty Co
3219 NE THOMPSON ST
PORTLAND, OR 97212 Date of Mailing: March 6, 2018
Policy Period: Apr 12, 2017 - Apr 12, 2018
Page 1 of 1
WILLIS-CLAY INS INC
1-503-661-9095
Online Service
prog ressiveagent.com
Customer Service
1-800-444-4487
Your policy has been reinstated
Thank you for your payment of $1,742.60. We recently sent you a cancellation notice stating that your policy was
canceled on March 7, 2018. We have now reinstated your policy effective March 7, 2018. There was no lapse in your
coverage.
We appreciate having you as our customer.
Form 6270 (10/10)
WILLIS-CLAY INS INC PR499/7E.fJfME'
202 SE 181ST AVE 206 COMMERC/AL
PORTLAND, OR 97233
Policy number: 06368027-6
Underwritten by:
Artisan and Truckers Casualty Co
Insured:
CITY OF ASHLAND MARK A SEDER
20 E MAIN ST March 8, 2018
ASHLAND, OR 97520 Policy Period: Apr 12, 2018 - Apr 12, 2019
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland, OH 44101
1-800-444-4487
Name of Person or Organization For customer service, 24 hours a day,
CITY OF ASHLAND 7 days a week
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: 06368027-6
Issued to (Name of Insured): MARK A SEDER
PATRICIA SEDER
Effective date of endorsement: 04/12/2018 Policy expiration date: 04/12/2019
Form 1198 (01104)
- - - - - - - - - -
WILLIS-CLAY INS INC P/4'DMEMAY
202 SE 181ST AVE 206 COMMERCIAL
PORTLAND, OR 97233
Policy number: 06368027-6
Underwritten by:
Artisan and Truckers Casualty Co
Insured:
CITY OF ASHLAND MARK A SEDER
20 E MAIN ST March 8, 2018
ASHLAND, OR 97520
Policy Period: Apr 12, 2018 -Apr 12, 2019
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland, OH 44101
1-800-444-4487
Name of Person or Organization For customer service, 24 hours a day,
CITY OF ASHLAND 7 days a week
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: 06368027-6
Issued to (Name of Insured): MARKA SEDER
PATRICIA SEDER
Effective date of endorsement: 04112/2018 Policy expiration date: 04/12/2019
Form 1198 (01;04)
WILLIS-CLAY INS INC AR499 I.FUML
202 SE 181ST AVE 206 COMMERC/AL
PORTLAND, OR 97233
Policy number: 06368027-6
Underwritten by:
Artisan and Truckers Casualty Co
Insured:
CITY OF ASHLAND MARKA SEDER
20 E MAIN ST March 8, 2018
ASHLAND, OR 97520
Policy Period: Apr 12, 2018 -Apr 12, 2019
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland; OH 44101
1-800-444-4487
Name of Person or Organization For customer service, 24 hours a day,
CITY OF ASHLAND 7 days a week
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: 06368027-6
Issued to (Name of Insured): MARK A SEDER
PATRICIA SEDER
Effective date of endorsement: 04/12/2018 Policy expiration date: 04/12/2019
Form 1198 (01/04)
-
L
WILLIS-CLAY INS INC M98REW111F
202 SE 181ST AVE 206 COMMERCIAL
PORTLAND, OR 97233
Policy number: 06368027-6
Underwritten by:
Artisan and Truckers Casualty Co
Insured:
CITY OF ASHLAND MARKA SEDER
20 E MAIN ST March 8, 2018
ASHLAND, OR 97520
Policy Period: Apr 12, 2018 -Apr 12, 2019
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland, OH 44101
1-800-444-4487
Name of Person or Organization For customer service, 24 hours a day,
CITY OF ASHLAND 7 days a week
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: 06368027-6
Issued to (Name of Insured): MARK A SEDER
PATRICIA SEDER
Effective date of endorsement: 04/12/2018 Policy expiration date: 04/12/2019
Form 1198 (01/04)
i QCrr c
WILLIS-CLAY INS INC APQ94GRE ~~L
202 SE 181ST AVE 206 COMMERCIAL
PORTLAND, OR 97233
Policy number: 06368027-6
Underwritten by:
Artisan and Truckers Casualty Co
Insured:
CITY OF ASHLAND MARK A SEDER
20 E MAIN ST March 8, 2018
ASHLAND, OR 97520
Policy Penod: Apr 12, 2018 -Apr 12, 2019
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Additional insured endorsement Cleveland, OH 44101
1-800-444-4487
Name of Person or Organization For customer service, 24 hours a day,
CITY OF ASHLAND 7 days a week
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: 06368027-6
Issued to ((Jame of Insured). MARKA SEDER
PATRICIA SEDER
Effective date of endorsement: 0411212018 Policy expiration date: 04/12/2019
Form 1 198 (01,04)
WILLIE-CLAY INS INC
4goGREWIlf*
206 (JILL J (/L
202 SE 18 1ST AVE 2
PORTLAND, OR 97233 COMM£RC/AL
MARK SEDER
ARCHITECTURE+URBAN DESIGN
MARK A SEDER Policy Number: 06368027-9
PATRICIA SEDER Underwritten by:
ARCHITECTURE+URBAN DESIGN Artisan and Truckers Casualty Co
3219 NE THOMPSON ST
PORTLAND, OR 97212 Date of Mailing: March 6, 2018
Policy Period: Apr 12, 2017 - Apr 12, 2018
Pagel of 1
WILLIS-CLAY INS INC
1-503-661-9095
Online Service
progressi veagent.com
Customer Service
1-800-444-4487
Your policy has been reinstated
Thank you for your payment of $1,742.60. We recently sent you a cancellation notice stating that your policy was
canceled on March 7, 2018. We have now reinstated your policy effective March 7, 2018. There was no lapse in your
coverage.
We appreciate having you as our customer.
Form 6270 (10110)