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ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYVY)
5/9/2006
PRODUCER (541) 772-1111 FAX (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION
Security Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOr AMEND, EXTEND OR
707 Murphy Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Oregon Automobile Ins Cel 23922
Western Rock Reduction INSURERB SAIF Corporation
POBox 1269 INSURER C
INSURER D
Shady Cove OR 97539 INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAllED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CON"TlRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERllFICATE 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
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYY) DATE (MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
- ~~~~~~9E~~J~~~nce\
X 5MMERCIAL GENERAL LIABILITY $ 100,000
- CLAIMS MADE ~ OCCUR 8/1/2006 8/1/2007
A COB145491 MED EXP (Anyone pe'rson) $ 5,000
-
- PERSONAL & ADV IN.JURY $ 1,000,000
- GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREnE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
I PRO. n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
- (Ea accident) $
~ ANY AUTO
A ALL OWNED AUTOS COB145491 8/1/2006 8/1/2007 BODILY INJURY
- (Per person) $
- SCHEDULED AUTOS
- HIRFrJ Al JTOS BODILY INJURY
$
NON.OWNED AUTOS (Per accident)
-
PROPERTY DAMAGE $
(Per aCCident)
RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EACESSlUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000
I ~ OCCUR D CLAIMS MADE $
AGGREGATE
$
A R DEDUCTIBLE C08145491 8/1/2006 8/1/2007 $
RETENTION $ $
B WORKERS COMPENSATION AND I we STATU.; I 10TH.
TORY LIMITS ER
EMPLOYERS' LIABILITY 500,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? B11621 10/1/2005 10/1/2006 E.L. DISEASE - EA EMPLOYEE $ 500,000
If yes, describe under 500,000
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: Asphalt Crushing. Verification of insurance. Subject to policy terms, condi tions and excl uS.ions.
CERTIFICA TE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES I~E CANCELLED BEFORE THE
City of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Attn: Dawn Lamb 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
Risk Management Dept. -
FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
20 East Main
Ashland, OR 97520 INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE s: .......... ~
S Wilson, AAI, Alr/su ~-v.<- 1-'). uA.
ACORD 26 (2001/08)
INS026 (0108)06 AMS
@ ACORD CORPORATION 1988
VMP Mortgage Solutions, Inc. (800)327.0545
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