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HomeMy WebLinkAboutInsurance Certificate: Ashland Flowe shop and Green House From: AOPEL INSURANCFax: (253) 759-2200 To: fax: (541) 552.2017 Page 2 of 3 08113i2018 1:58 PM Client: 175644 ASHLFLOW DATE (MMIDDIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 811312018 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(ies) 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Therese Pritchett Propel Insurance I PHONE 800 499-0933 FAX 866 577-1326 (AIC No, Ext): (AIC No): Medford Workers Compensation E-MAIL ADDRESS: Therese.PritchettProPelinsurance.com P O Box 936 INSURER(S) AFFORDING COVERAGE NAIC Medford, OR 97501 INSURER A : SAIF Corporation 36196 INSURED INSURER B : Ashland Flower Shop and Green Houses Inc INSURER C P.O. Box 2037 INSURER D : Phoenix, OR 97535-1027 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 CONTRACTOR 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDDNYYY) (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ R& tMit CLAIMS-MADE OCCUR EMISEE(Eaoccurr0ence $ i MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRO- LOC PRODUCTS - COMP/OP AGG $ POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION 764581 9!0112018 0910112019 X SPER TATUTE EOTH AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN E.L EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? F-1 N 1 A (Mandatory in NH) El. DISEASE - EA EMPLOYEE $500,000 It yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Landscaping Maintenance of Ashland Main 1 Heiman Median "Gilligan's Island" CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E Main St ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE I_ (f~ ' I 6C © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3309222/M3294671 LA H00 From: PRCPEIINSURANCFax: (253) 759-2200 To: Fax: (541) 552.2017 Page 3 of 3 08;13;2018 1:58 PM • This page has been left blank intentionally