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Home My WebLink AboutKey Line Construction A COB!),., CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/21/2006 PRODUCER (541) 772-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cramer & Giles Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 707 Murphy Road AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 I INSURERS AFFORDING COVERAGE NAICtf. .~. INSURED ,INSURERA Financial Pacific Ins Co r-- -- Key Line Construction, Inc. f INSURER B -- -~ 6687 Tala Road . INSURER C lll";~RER D ~ Central Point OR 97502 I ! INSURER E OVFRAGES 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. -- I~f: ~~~6 Type or INSURANce POLICY NUMOCR P~l+~~ ~~~ggmlE Pgk'fJ(~:'~6)~~N I LIMITS ~NERAL LIABILITY I f'ACH OCCURRENc;.L___~ ~_~~L~OO, goo ~ OMERCIAL GENERAL LIABILITY 8~~~~~~?E~~~Jl~?enc€L- s 100,000 1-_ CLAIMS MADE ~ OC;r:tJR -. ~- A X - 173496B 11/22/2006 11/22/2007 MED EXP (An" one nerson S 5c.QQQ - PERSONAL & ADV INJURY S 1,000, .o..QQ - GENERAL AGGREGATE S 2,OOO,OQ.Cl I -il'1. AGGREnE LIMIT APlES PER PRODUCTS - COMP/OP AGG S 2,OOO,QQ2 X POLICY jgc?i LOC AI ~TOMOBILE LIABILITY COMBINED SINGLE liMIT S 1,000,000 (Ea aCCIdent) - ANY AUTO -- - ALL UVVNI=U AU I US 173496B 11/22/2006 11/22/2007 BODILY INJURY I (Per personl S ~ SCHEDULED AUTOS ~ HIRED AUTOS , BODILY INJURY S X NON-OWNED AUTOS i (Per accident) I------ ----- ! PRO!'ERTY DAMAGE S (Per aCCIdent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S R ANY AUTO .-- o rHER THAN -leA A{;J2_ ~----- ---- -.------- AUTO ONL Y AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S 2,000,000 o OCCUR D CLAIMS MADE ~~GATE S _---.l:.., 000, OQ.Q s AI g DEDUCTIBLE 922533B 11/22/2006 11/22/2007 s X RETUITIOfJ $ 0 s I WORKERS COMPENSATION AND I_WCSlf\TU-; I OTH- TORY LIMITS ER -- EMPLOYERS' LIABILITY ~ ANY PROPRIETOR/PARTNER/EXECUTIVE ~. EACH ACCIDENT S -- OFFICER/MEMBER EXCLUDED? ~_ DISEASE - EA EMPLOYEE $ If yes, describe under -------- SPECIAL PROVISIONS below E L DISEASE - POLICY LIMIT S OTHER I I DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Ashland, its officers, and employees shall be named as Additional Insured as respects to General Liability. Re: Quincy Street Primary Fault Repair Project #000085 CERTIFICATE HOLDER L-... ACORD 25 (2001108) INS025 (0108).08 AMS 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 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 /J, () C./ (1..(-<..f\("[ uta <<erll/. Amber SlClt-tpry/AMBESL ' ~) @ACORD CORPORATION 1988 WOltersKlllwerFlnDnciaiservlceCITY RECORDER'S COpy Page 1 012 City of Ashland 90 N Mountain Avenue Ashland, OR 97520 t~ ™ ACORo'M CERTIFICATE OF LIABILITY INSURANCE DA TE (MMfDDIYYYYJ 11/21/2006 PRODUCER (541) 772-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cramer & Giles Insurance Agency ONLY AND CONrERS NO RIGHTS UPON THE CERTlrlCATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 707 Murphy Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 INSURERS AFFORDING COVERAGE NAICn .-- ._-- INSURED INSURER A Financial Pacific Ins Co ------~ Key Line Construction, Inc. INSURER B ~~ -- 6687 Tolo Road !I'JSUR~R c -- --,----~ ~"D __n -- Central Point OR 97502 INSURER E CO\fERAGFS 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. -- l~lS: I~o,.,~~ TyrC or INSURANOC rOLlOY NUMDCR pgkm~~~gg/~~F PgklfJI~~~6)~!gN LIMITS GENERAL LIABILITY _~ACH Q<;;GLJ!WE;NCIC:____ s __:1..,0_00,00_0 ~l S~~6~~J~~J~~nce\ S 100.!~ ~ OMMERCIAL GENERAL LIABILITY A I-- CLAIMS MADE ~ 0'-'-1 JR 173496B 11/22/2006 11/22/2007 MED EXP IAn v one Derson\ S 5,009 I-- PERSONAL & AD\iINJURY S 1,000-,- 0~2 I-- I GENERA.L AGGREGATE S 2,000,000 r.~r AGGRFnE LIMIT APlS PER i PRODUCTS. COMP/OP AGG S 2,000,000 PRO. i POLICY JECT LOC ~TOMOBILE LIABILITY I COMBII'lED SINGLE LIMIT S e--- ANY AUTO i (Ea accident) -- e--- ALL UVVNcU AU I U:S BODILY INJURY S :SCHEDULED AUTOS (Per persm) I-- -- f-- HIRED AUTOS BODIL Y INJURY S ,IO,I.O~IED AUTOS (Per acclclent) e--- I-- -_. PROPERTY DAMAG E S (Per accielent) RAGE LIABILITY AUTO ONLY. EA ACCIDENT S ANY AUTO OTHER THAN t',[JA<;;_c:.. tL- ----- AUTO ONLY AGG S EXCESS/UMBRELLA LIABILITY EACf-' OCCURRENCE: S -- =:J OCCUR D CLAIMS MADE AGGREGATE S I S -- r ==1 DEDUCTIBLE f- S RETEI~TION $ S WORKERS COMPENSATION AND I /~~,9Ii'JNs I CJTH ER -- EMPLOYERS' LIABILITY - : I E LEACH ACCIDE:NT S ANY PROPRIETOR/PARTNER/EXeCUTIVE ~~. DISEASE. [A EMPLOYEE S -- OFFICER/MEMBER EXCLUDED? If yes, describe under -- SPECIAL PROVISIONS below ' EL DISEASE. POLICY LIMIT S OTHER \ DESCRIPTION OF OPERA TIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 10 Day Notice of Cancellation for Non-Payment of Premium. Subject to Policy Limits, Terms Conditions and Exclusions. CERTIFICA TE HOLDER CANCELLA TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Ashland EXPIRA TION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 90 N Mountain 30 DA YS WRITTEN NOTICE TO THE CERTIFICA TE HOLDER NAMED TO THE LEFT, BUT Ashland, OR 97520 ----- FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE (il,Acf S'Ia tt"ZJ Amber Slattery/AMBESL - ACORD 25 (2001/08) INS025 (0108).08 AMS (::1 ™ @ ACORD CORPORATION 1988 VVoltersKluwerFIIIOIlCialSel,JjceCITY RECORDER'S COpy Page1of2