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ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID lm1 DATE (MM/DDIYYYY)
MOLEC-l 10/10/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Clackamas Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 309-15661 SE 82nd Dr. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clackamas OR 97015
Phone: 503-655-6344 Fax: 503-655-2035 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Oregon Automobile Insurance CO
INSURER B:
Moleculart Inc. INSURER C:
247 Schut Road INSURER D:
Castle Rock WA 98611
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.
rDJ'Y"
LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE MM/DD1YY DATE"MM/DDNYi' LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY C12 13-56-46 10/10/06 10/10/07 ~~:SES (E~~r~nce\ $ 100,000
l CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
-
GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000
I .nPRO. nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
-
A ~ ANY AUTO C12 13-56-46 10/10/06 10/10/07 (Ea accident)
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
-
- HIRED AUTOS BODILY INJURY
(Par accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accidant)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $
=:J OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1Mmi I IUJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETORlPARTNERlEXe:CUTIVE --~- --------.--
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~~~MtS~W6'v~~1~~s below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
All operations of the named insured subject to policy conditions,
limitations, and exclusions.
CITY RECORDER'S COpy
CERTIFICATE HOLDER
City of Ashland
Department of Public Works
20 E Main
Ashland OR 97520
CANCELLATION
CITYOO2 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
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Shell
ACORD 25 (2001108)