HomeMy WebLinkAboutInsurance Certificate: Jodi & David Geigle
GEIGJ01 OP
A~CO~RO CERTIFICATE OF LIABILITY INSURANCE 07/03/2 DATE/03/2 Y018
8
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsements .
acr Debbie Wheeler
PRODUCER 541-899-9535 CONr
NAME:
The Insurance Center, Inc. PHONE 541-899-9535 FAX 541-899-9532
240 West "C" Street (A/C, No, Ext : (,C, No
P 0 BOX 6 ADD IL
Jacksonville, OR 97530
George Wheeler INSURER(S) AFFORDING COVERAGE NAIL #
INSURER A : Progressive Ins. Companies
INSURED Jodi & David Geigle INSURER B :
PO BOX 782
Jacksonville, OR 97530 INSURER C :
INSURER D
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LWITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
CLAIMS-MADE ❑ OCCUR DAf MGE TO REONTED $
MED EXP An one person) $
PERSONAL & ADV INJURY $
I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
POLICY D jper FILOC PRODUCTS - COMP/OP AGG $ _
OTHER:
A AUTOMOBILE LIABILITY C(Ea accident OMBINED SINGLE LIMIT $
ANY AUTO 913970283 03/1812018 0911812018 BODILY INJURY Per Person) 50,000
OWNED SCHEDULED 100,000
AUTOS ONLY AUTOS BODILY INJURE Per accident
HIRE NON-pWNEp PReOPERTY DAMAGE $ 50,000
AUT~S ONLY AUTOS ONLY
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ PERTUTF OTH-
WORKERS COMPENSATION STA ER
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE E.L. FJACtACCIDENT $
OFFICER/MEMBER EXCLUDED? N I A
(Mandatory in NH) E.L. DISEMPLOYEE
If yes, describe under
DESCRIPTION F OPERATIONS Wow E.L. DISEASE -P I IMIT
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required)
2005 FORD F150 PK 1FTRF14505KC62095
CERTIFICATE HOLDER A ELLATION
CITYASH
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland
Attn Kaylea AUTHORIZED REPRESENTATIVE
51 Winbum Way George Wheeler
Ashland, OR 97520
ACORD 25 (2016103) C 1 -20 C RPORATION. All rights reserved.
The ACORD name and logo are registered marks of CORD