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~CORD... CERTIFICATE OF LIABILITY INSURANCE 'OP ID K .;.....,......DDtY"NYl
SOUT-14 07/11/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Western States Ins. - M8dfo~d HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
739 Medford Center ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
Medford OR 97504
Phone: 541-779-1321 Fax: 541-779-91B7 INSURERS AFFORDING COVERAGE NAIC'
INSURED INSURER ~ Safeoo 24740
INSURER 8;
SC?uthern Oregon Repe~toz:y INSURER c:
Siners
PO x 1091 INSURER D:
Ashland OR 97520
INSURER E;
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED '1'0 THe INSURED NAMED ABOIIE FOR THE POLICY PERIOO IND1CATI<O. NOTWJTl.lSTANDING
NlY REQUIREMENT. TERM OR CONDrrlON OF AllY cON'T'RACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CeRTIFICATE MAY BE ISSUED OR
MAY pER'T'A1N, THE INsuRANCE AfFORDED BY THE POUC1Es DESCRIIlED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS NlD CONDmONS OF SUCH
POlICIES. AGGRec;.6.TE LIMITS SIolOWN MA,Y HAVE BEEN REDUCED 8'f PAID CLAIMS.
POLICY NUMBER ~1IEFFf~ POL~I=Rf~ LIMITS
LTR NSM TY'PE OF INSURANCE DATI! 1111IO DATE IIM1DD
~ERAI.I.IAIlIL.1TY EACH OCCURRENCE: S1 000 000
A X ~ COMMERCIAL GENERAl. LIABILI1Y OlCE8636697 06/01/06 06/01/07 =~~SY~=~1 $200 000
- =:J CLAIMS MADe [i] OCClIR MED EXP (AtrJ one pet.on) $10.000
- PERSONAl. & ADV INJURY Ii 1 .000.000
GENERAL AGGREGATE $2,000,000
-
~L AGGRfnE::~ APnS PeR; PRODUCTS. CCMP{OP AGG $2.000.000
POLICY JECT Loe
~UTOMOBlLE UABILIlY COMBINED SINGLE UM1T $
ANVAUTO (Ea accfdenl)
~
~ ALL OWNED AUTOS BOOIL Y INJURY
S
SCHEDULED AurOS (Per person)
~
~ HIRED AUTOS BODIL'f INJURY
(P.... ;occ1denl) $
NON<>WNED ALlTOS
-
I PROPERTY DAMAGE $
(Pet' accident)
=1'"'"'"' AlJTO ONLY. EA I<CCIDENT $
ANY AUTO OTlolER THAN EAACC $
AUTO ONLY; AGG $
EXceSS/UIIBRELLA LIABIUTY EACH OCCURRENCE $
L:loCCUR 0 CLA1~ MADE AGGREGATE Ii
$
R DEDUCTIBLE $
FlI.TENTION $ $
WORKERS COMPeNSATION AND ITORYLlMITS I IO~~'
EMPLOYERS" UABlLIlY E.L. EACH ACCIDENT $
ANYPR~ETO~ARTNE~CUT~
OFFICERlMEMBER EXCLUDEO? H. DISEASE. EA EMPLOYEE $
It YN. de8Crile \Jlder E.L. DISEASE. POLICY LIMIT $
SPECIAL PROVISIONS DeIoW
OTHER
DESCRIPTION OF OI'ERA11ONS {lOCATIONS I VEHICLES I EXel.USIONS ADDED BY ENDQRSEIIEHT I SPECIAL PROVI8IONS
C.i. ty of Ashland its officers and employees ue additional insured.
ci ty of Ashland
20 E Main street
Ashland OR 97520
CANCELLATION
SHOULD AI<< OF THE aBOVe DESCRIBED POLICIES BE CANCELLED IlEFOIU! THE EXI'lRATlON
DATe THEREOF. THE ISSUING INSURER WlL.L ENDEAVOR TO MAlL ~ DAYS WltITTEM
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FALURe TO DO so SHALL
IMPOSE NO 08~11ON OR LIABILITY OF APlY I(IND UPON THE INSURER, ITS AGENTS Oil
IW'RESENTATIVea.
aUTHORIZED RePRESENTATIVE
@ACORD CORPORATION 1$188
CERTIFICATE HOLDER
ACORD 26 (2001108)
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