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ACORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID C11 DATE (MMIDDIYYYY)
PUMPP-1 11/02/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlm
ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Monroe & Monroe Insurance Agen HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2921 Galleria Dr. , Suite 102 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Arlington TX 76011
Phone: 817-640-5035 Fax:817-640-0131 INSURERS AFFORDING COVERAGE NAIC#
INSURED il tSLIR[R tJ. Mid-Continent Casualty CO.
!!JSUREr:( E
Pump PiEe & Tank Services II ,:::~I_IR~F :.:
Robert McHenry
Box 146 !I'j':-,IJRER [)
Talent OR 97540
iIJ~;i iRCR L
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 ADD'L POLICY EFFECTIVE POLICY EXPIRATION
L TR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) DATE (MMIDD/YY)
GENERAL LIABILITY
LIMITS
r:L'W'v~:::- fJ/I.nF
X OCCUR
f\~E!J EXP (/~n\, O!le pe~~C''')
5 1,000,000
$ 100,000
sO
51,000,000
52,000,000
52,000,000
A
X COMMERCIAL '3ENERAL UABiLlTY
04GL653326
11/15/06
11/15/07
EACH OCCURRENCC
DI\Mr':GETO'RENTED
PREMISES lEa occurenee)
X Pollution Liab
X Professional Liab
X
GEI.I'L ;'i33REGATE L11.!IT i\PPLES PER
PR':',
L'Er-,T
PERSONA,L & ADV IIM:RY
GEIJERAL AGGREG~TE
PRODUCTS. COMPiOP AGG
PDL1:Y
LOC
AUTOMOBILE LIABILITY
sir ;GLE llrv11T
accident)
1,1 i ~_
- ~[L, I~['--i i.:>.
IIJJIIRY
perso'l!
.-,qE~) L,UT,~~
- " i' ~ [ :
S==-'I~ ; I~ JAI';'l'
'i--'e' ,lecKier,t'.
I
I....----.~AR^GE .IABILlTY
i
C":~'~'PE.:RT T SA:.~':, --=,;:-
';";PI "1;('lcler+
.. .='111 ',"
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EXCESS/UMBRELLA LIABiliTY
[~~, - (,I Jr;:R[:J(A~
,:>:.C_,R
,-,L ,'-' '.1 i'"ilA~,=-
A-:;::;=-<t:,:',li,TE
::C=-Jij( TiEU::
RE rENTIO!'~
WORKERS COMPENSATION AND
EMPLOYER";' UABILlTY
Mly
"
TORY L1MI,S ER
[L EACH ACClDEIJT
E' L D!~E".SE E;' EI~PL.C.vFE S
below
E L DISEASE POLICY LIMIT 5
OTHER
A Equipment Floater
04IM18478
11/15/06
11/15/07
Owned Equ
4,900
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
I
I
I
I
I
I
i
I
CASHLAN
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ElPIRATIONI
DATE THEREOF THE ISSUIIJG INSURER WILL ENDEAVOR TO MA.IL 10 DAYS ,\RIITEIJ
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FA.ILURE TO DO SO SHALe
City of Ashland
20 E, Main street
Ashland OR 97520
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES
A~R~~A 1\
~
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988