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ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
07/27/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CNA Sales & Service Center ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PO Box 946580 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Maitland, FL 32794.6580
877 724.2669 INSURERS AFFORDING COVERAGE NAIC#
INSURED .c ..' INSURER A: National Fire Insurance Company
Bob's Golf Shophlc. ) ,--...-., - - _._~
I -- -. -
3010 Highway 66 INSURER B:
INSURER C:
Ashland~ OR 97520 INSURER D:
INSURER E:
Client#: 48121
BOBSGOLF
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>}{~1:'~~8,%E P~~fl,~r.:;~~N LIMITS
A GENERAL LIABILITY 2084398946 07/13/06 07/13/07 EACH OCCURRENCE $1.000.000
f-- ~~~~~U9E~~~"n~e\
X COMMERCIAL GENERAL LIABILITY $300 000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10000
PERSONAL & ADV INJURY $1.000.000
GENERAL AGGREGATE $2.000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2.000.000
11 POLICY n ~~8T lXl LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
f--
ALL OWNED AUTOS BODILY INJURY
I-- (Per person) $
SCHEDULED AUTOS
f--
HIRED AUTOS BODILY INJURY
- (Per accident) $.
- NON-OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
OESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I /ri~.;~~~s I IO~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is Named as Additional Insured . Managers or Lessors
of Premises. AUG -2 2006
3070 HIGHWAY 66; ASHLAND, OR ~._._"...-.,,.__,._._., ~,........_~",,", _~, .....d '_.
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 .....30.... DAYS WRITTEN
340 South Pioneer Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAtLURE TO DO SO SHALL
Ashland, OR 97520 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESE~TlVE
~crrf' -- K
ACORD 25 (2001/08) 1 of 2
#121638
TGD
@ ACORD CORPORATION 1988