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ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY)
12/08/2006
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WESTERN STATES INSURANCE AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBOX 68 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ASHLAND, OR 97520
(888) 661-3938
XW894 882 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A:THE CHARTER OAK FIRE INSURANCE COMPANY
SANDLER FILMS, INC
391 DEAD INDIAN MEMORIAL RD INSURER B: THE TRAVELERS INDEMNITY COMPANY
JEANETTE HUTCHINSON INSURER C:
ASHLAND, OR 97520 INSURER D:
I 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 ADD' POLICY EFFECTIVE POLICY EXPIRATION
ITR I'N"Rr TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS
A X GENERAL lIABIITY 680-3463C999-07 01/25/2007 01/25/2008 EACH OCCURRENCE $ 1 000 000
-
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000
~CLAIMS MADE [K] OCCUR PRFMI!,;F!,;
f-- MED EXP IAnv one personl $ 5,000
X HIRED AUTO
X PERSONAL & ADV INJURY $1,000,000
NON OWNED AUTO
GENERAL AGGREGATE $ 2,000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP OP AGG $ 2,000,000
Xl n PRO- nl
X POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea accident) $
- ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
- IPer person)
f-- SCHEDULED AUTOS
I-- HIRED AUTOS BODILY INJURY
IPer accidentl $
I-- NON-OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
==i ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
B EXCESS/UMBRELLA LIABILITY CUP-3850Y96A-07 01/25/2007 01/25/2008 EACH OCCURRENCE $1,000,000
~ OCCUR D CLAIMS MADE AGGREGATE $1,000,000
$
~ ~EDUCTIBLE $
X RETENTION $5,000 $
WORKERS COMPENSATION AND I T~~~I~;Ys I I OJ~
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED - STATE OR POL SUBDIVISIONS-PERMITS-PRM
CERTIFICATE HOLDER
CANCELLATION
CITY OF ASHLAND
20 E MAIN STREET
ASHLAND, OR 97520
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
I
ACORD 25 (2001/08l