HomeMy WebLinkAboutInsurance Certificate: Mountain View Paving Incwww.saif.com
Oregon Workers' Compensation
Certificate of Insurance
Mail to:
MOUNTAIN VIEW PAVING INC
PO BOX 508
TALENT, OR 97540-0508
Certificate holder:
CITY OF ASHLAND
90 N MOUNTAIN AVE
ASHLAND, OR 97520
Work.
Life,
Oregon.
The policy of insurance listed below has been issued to the insured named below for the policy period
indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of
such policy; this policy is subject to change or cancellation at any time.
Insured
Mountain View Paving Inc
PO Box 508
Talent, OR 97540-0508
Producer/contact
Hub International Northwest LLC-Eugene
Mike Godfrey
541.650,6772 mike.godfrey@hubinternational.com
Issued 08/29/2024 Limits of liability
Policy 496578 Bodily Injury by Accident $500,000 each accident
Period 10/01/2024 to 10/01/2025 Bodily Injury by Disease $500,000 each employee
Body Injury by Disease $500,000 policy limit
Description of operations/locations/special items
All operations performed by the named insured for the certificate holder in accordance with policy terms and
conditions.
Important
This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate
does not amend, extend or alter the coverage afforded by the policies above. This
certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the
certificate holder.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN
ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW, SAIF WILL ENDEAVOR TO PROVIDE
WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE.
Authorized representative
Chip Terhune
President and CEO
Po I i c y_ C L CA_Ce rt i 6 ca to Cf I r s u r a n c e
400 High Street SE
Saiem, OR 97312
P: 800.285.8525
F: 503.584.9812
www.saif.com
Work.
Life.
Oregon Workers' Compensation Oregon.
Certificate of Insurance
Mail to: Certificate holder:
MOUNTAIN VIEW PAVING INC CITY OF ASHLAND, PARKS AND RECREATION
PO BOX 508 DEPARTMENT
TALENT, OR 97540-0508 340 S. PIONEER STREET
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named below for the policy period
indicated. The insurance afforded by this policy is subject to all the terms, exclusions and conditions of
such policy; this policy is subject to change or cancellation at any time.
Insured
Producer/contact
Mountain View Paving Inc
Hub International Northwest LLC-Eugene
PO Box 508
Mike Godfrey
Talent, OR 97540-0508
541.650.6772 mike,godfroy@hubin.ternational.com
Issued 08/29/2024
Limits of liability
Policy 496578
Bodily Injury by Accident $500,000 each accident
Period 10/01/2024 to 10/01/2025
Bodily Injury by Disease $500,000 each employee
Body Injury by Disease $500,000 policy limit
Description of operations/locations/special items
Attn: All operations preformed by the named insured for the certificate holder in accordance with the policy terms and
conditions.
Important
This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate
does not amend, extend or alter the coverage afforded by the policies above. This
certificate does not constitute a contract between the issuing insurer, authorized representative or producer and the
certificate holder.
CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, NOTICE WILL BE DELIVERED TO THE POLICYHOLDER AND CERTIFICATE HOLDER IN
ACCORDANCE WITH THE POLICY PROVISIONS AND OREGON LAW. SAIF WILL ENDEAVOR TO PROVIDE
WRITTEN NOTICE WITHIN 30 DAYS WHENEVER POSSIBLE.
Authorized representative
Chip Terhune
President and CEO
Pe l i c y_ OL CA_Cc r, i f i cat e O fir s u ran cc
400 High Street SE
Salem, OR 97312
P: 800.285.8525
F: 503.584.9812