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HomeMy WebLinkAboutInsurance Certificate: Dry Creek Landfill LLC Client#:1137013 ROGUEWAS ACORI1 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/01/2021 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 CONTACT Teresa Weston USI Insurance Services NW PHONE FAX (A/c,No,Ext):541 685-5300 (A/C,No): 975 Oak Street,Suite 900 E-MAIL teresa.weston@usi.com Eugene,OR 97401 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 541 685-5300 INSURER A:Greenwich Insurance Company 22322 INSURED INSURER B:XL Specialty Insurance Company 37885 Dry Creek Landfill,LLC INSURER C: One West Main St.,Suite 401 Medford,OR 97501 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 ISySUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GEC003582710 10/01/2021 10/01/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $100,000 X BI/PD Ded:1,000 MED EXP(Any one person) $5,000 _ PERSONAL&ADV INJURY $1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO POLICY ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 7 OTHER: $ A AUTOMOBILE LIABILITY AEC003582410 10/01/2021 10/01/2022 EDa aocideD SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED — AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE • AUTOS ONLY AUTOS ONLY (Per accident) B x UMBRELLA LIAB X OCCUR UEC003582510 10/01/2021 10/01/2022 EACH OCCURRENCE $3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $3,000,000 DED X RETENTION$$10,000 • $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.' EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Ashland its officers,agents and employees are added as additional insureds. - 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 ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520-0000 , AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S33568621/M33467130 LBSZP This page has been left blank intentionally. r