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ACORD~ CERTIFICATE OF LIABILITY INSURANCE CSR SN I DATE (MM/DDNYVY)
MOUNT-6 09/08/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlm
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Cramer & Giles Ins., Inc. HOLDER. THIS CERTIFICATE DOES NOT AIVEND, EXTEND OR
P. O. Box 70206 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Eugene OR 97401
Phone: 541-485-6633 Fax:541-485-3946 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Oregon Autcmobile J:n8uranae Co
INSURER B: SAIF Corporation
Mountain View Paving, Inc. INSURER C:
2560 E Main st. INSURER D:
Ashland OR 97520
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BEISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS, EXCLUSIONS AND CONDI110NS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSRi TYPE OF INSURANCE POLICY NUMBER Pq\;!~T,~~t..E~J.IVE I P8k~'1l ~:;b~JWN LIMII"S
DATE MMlDD1YY)
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
i--
A X COMMERCIAL GENERAL LIABILITY C05154211 09/25/06 09/25/07 PREMISES (Ea occurence) $ 100,000
i-- :=J CLAIMS MADE [!] OCCUR
i-- MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,000,000
CENERALACCRECATE $ 2 ,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $2,000,000
II POLICY n ~~g: n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
r-- $ 1,000,000
A X ANY AUTO C05154211 09/25/06 09/25/07 (Ea accident)
r--
ALL OWNED AUTOS BODILY INJURY
r-- $
SCHEDULED AUTOS (Per person)
r--
HIRED AUTOS BODILY INJURY
r-- $
NON-OWNED AUTOS (Per accident)
i--
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=l ANY AUTO OTHER THAN EA ACe $
AUTO ONLY: AGe:; $
EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
A ~ OCCUR D CLAIMS MADE C05154211 09/25/06 09/25/07 AGGREGATE $1,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERSCOMP,lil.lSATlC~1 A~!D . X ! TORY LIMITS I jUER
B EMPLOYERS' LIABILITY 496578 10/01/06 10/01/07 E.L. EACH ACCIDENT $ 500000
ANY PROPRIETORlPARTNERlEXECUTlVE
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500000
~ ~es, describe under E.L. DISEASE. POLICY LIMIT $ 500000
S EOAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE ASHLAND AIRPORT
CITY RECORDER'S COpy
CERTIFICATE HOLDER
CANCELLATION
ASHLAND
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIV S.
ESENT
CITY OF ASHLAND
90 N. MOUNTAIN
ASHLAND OR 97520
@ ACORD CORPORATION 1988
ACORD 25 (2001/08)