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Home My WebLink AboutC.F. Malm ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDfYYVY) 1 0/09/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI Northwest of Washington ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1001 Fourth Avenue, Suite 1800 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Seattle, WA 98154 206695-3100 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Liberty Insurance Underwriters Inc 19917 C. F. MaIm Engineers INSURER B: 5511 6th Avenue S INSURER C: Seattle,WA 98108 INSURER D: INSURER E: " Client#: 18744 CFMAL COVERAGES 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. LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PJ>A'4~1ri~f~8,wIE P~~fJ l':lr:'~~N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ - DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY $ I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ - PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ - GEN'L AGG~EnE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $ I PRO. n POLICY JECT LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) - I-- ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) I-- I-- HIRED AUTOS BODILY INJURY $ NON.OWNED AUTOS (Per accident) I-- I-- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACe $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ tJ OCCUR 0 CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I WC STATU. I IOJbl' EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ It yes, deSCribe under E.L. DISEASE. POLICY LIMIT $ SPECIAL PROVISIONS below A OTHER Professional AEE1973850106 09/30/06 09/30/07 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CITY RECORDER'S COpy CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Attn: Kari Olson NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 90 N. Mountain Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ashland, OR 97520 REPRESENTATIVES. I\UTHORIZED REPRESENTATIVE 5~ I-f V'M -r;;.... i;- ... ACORD 25 (2001/08) 1 of 2 #M199665 6MT @ ACORD CORPORATION 1988 ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE 09-26-2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI NORTHWEST/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 811817 P: (866)467-8730 F: (877) 905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED INSURER A: Hart ford Casualty Ins CO INSURER B: C F MALM ENGINEERS INSURER c: 5511 6TH AVE. S. INSURER D: SEATTLE WA 98108 INSURER E: COVERAGES 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER ~~~~Tr:~~~g~~ "8k!fUlrX~~lJ~~ LIMITS ~NERAL LIABILITY A f---~MMERCIALGENERALLlABILlTY 52 SBA PR8145 f--- ~ CLAIMS MADE lKJ OCCUR X Business Liab f--- f--- GEN'L AGGREGATE LIMIT APPLIES PER: -=-1 POLICY I-I j~8;- iX-I LOC ~TOMOBILE LIABILITY ANY AUTO I---- EACH OCCURRENCE $1, 000 , 000 11 /06 / 0 6 11/06 /07 FIRE DAMAGE (Anyone fire) $1 , 0 0 0 , 0 0 0 MED EXP (Anyone person) $1 0 , 0 0 0 PERSONAL & ADV INJURY $1, 000, 000 GENERAL AGGREGATE $2 , 000 , 000 PRODUCTS - COMP/OP AGG $2, 000, 000 ALL OWNED AUTOS I---- I---- SCHEDULED AUTOS f--- HIRED AUTOS NON-OWNED AUTOS f--- COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ I Per accident) PROPERTY DAMAGE $ I Per accident} GARAGE LIABILITY ~.. ANY AUTO EXCESS LIABILITY A t10 OCCUR U CLAIMS MADE 52 SBA PR8145 AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EA ACC $ AGG $ $1,000,000 $1,000,000 11/06/06 11/06/07 EACH OCCURRENCE AGGREGATE II DEDUCTIBLE IX1 RETENTION $I 0 , 0 0 0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 52 SBA PR8145 IWCSTATU-I IOTH- TORY LIMITS I ER 11 / 0 6 / 0 6 11 / 0 6 / 0 7 E.L.EACH ACCIDENT $1 , 0 0 0 , 0 0 0 E.L. DISEASE - EA EMPLOYEE $1, 000 , 000 E.L. DISEASE - POLICY LIMIT $1, 000 , 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CITY OF ASHLAND ATTN: KARl OLSON 90 N. Mountain Ave. Ashland, OR 97520 As required by written contract the certificate holder is included as additional insured, and coverage is primary and non-contributory and waiver of subrogation is included. Those usual to the Insured's Operations. CITY RECORDER'S COpy CERTIFICATE HOLDER I x I ADDITIONAL INSURED; INSURER LETTER:..a CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) 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 REPRESENTATIVES. A~~_ ACORD 25-S (7/97) e ACORD CORPORATION 1988