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ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYYI
04/24/2006
PRODUCER (541) 687 -1117 FAX (541)342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ward Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 10167 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Eugene, OR 97440
Rob Harvey INSURERS AFFORDING COVERAGE NAIC#
INSURED Bergeson - Boese & Assoc i ates I nc INSURER A: Hudson Specialty Ins Co
DBA: Pacific Northwest Dri II ing INSURER B: Nationwide Mutual Ins Company 23787
32986 Roberts Court INSURER C:
COburg, OR 97408 INSURER D:
INSURER E:
RECEIVED APR 2 8 2006,
C
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~M ~9.~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE P~W EXPIRATION LIMITS
GENERAL LIABILITY FEC6106785 04/30/2006 04/30/2007 EACH OCCURRENCE $ 1 ,000, OOC
-
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,00C
- o CLAIMS MADE 00 OCCUR
MED EXP (Anyone person) $ 5,00C
- 1 ,000, OOC
A PERSONAL & ADV INJURY $
- 2,000,00(
GENERAL AGGREGATE $
- 2,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG $
n 'nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY ACP7521541172 04/30/2006 04/30/2007 COMBINED SINGLE LIMIT
X ANY AUTO (Ea accident) $ 1 ,000, OOC
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
B -
X HIRED AUTOS BODILY INJURY
- (Per accident) $
X NON-0WNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $
==:J . OCCUR 0 CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I we STATU- I IOJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? E. L. DISEASE - EA EMPLOYEE $
~~~'MLS~~Vis~orNS ~ow E.L. DISEASE - POLICY LIMIT $
OTHER FEC6106785 04/30/2006 04/30/2007 LIMIT: $1,000,000
POLLUTION LIAB
A PROFESSIONAL LIAB FEC6106785 04/30/2006 04/30/2007 LIMIT: $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
HE CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE ADDED AS ADDITIONAL INSUREDS IF REQUIRED BY
NRITTEN CONTRACT
N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF ASHLAND
20 E MAIN STREET
ASHLAND, OR 97520
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
--,;J.J"^"-t d rk",:~,,;
Rob Harve /GLENDA
ACORD 25 (2001/08)
@ACORDCORPORATION 1988