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ACORD,. CERTIFICATE OF LIABILITY INSURANCE ~b~D S~ DATE (MM/DDfYYVY)
MAR U-1 01/11/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Protectors Insurance, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Pilot Rock Ins Agency LLC (CA) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 4669 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97501
Phone:541-773-5358 Fax:541-772-1906 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A SAIF Corporation
INSURER B: Marvland Casualty Company
Mar~ess & Associates Inc INSURER C:
PO ox 490 INSURER 0: l-lI.":,; ( "' C 1\/l""":'n
Medford OR 97501
INSURER E: . 'If! Ii..~"',.,
COVERAGES .IAN 11l ?nn7
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 ISSU~
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION U HUNTS PA VAtJ.
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. );
NsRi POLICY NUMBER i>OIJ~ir~fFEYJ,!XE PIRA~!gN LIMITS
LTR TYPE OF INSURANCE DATE MM/DDfYY DATE' fMMlDDNY
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
f---
B ~ COMMERCIAL GENERAL LIABILITY PAS00487480 01/03/07 01/03/08 PREMISES (Ea occurence) $1,000,000
h CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10,000
PERSONAL & ADV INJURY $1,000,000
-
~ See Other GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
I nPRO- n
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
B ~ ANY AUTO PAS00487480 01/03/07 01/03/08 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
- NON-OWNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
B ~ OCCUR D CLAIMS MADE PAS00487480 01/03/07 01/03/08 AGGREGATE $1,000,000
$
Fx=l DEDUCTIBLE $
X RETENTION no 000 $
WORKERS COMPENSATION AND I TORY L1Mtn3 I IUER-
A EMPLOYERS' LIABILITY 913785 01/01/07 01/01/08 E.L. EACH ACCIDENT $ 1000000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1000000
~~EM.tSp~ov~~1o~s below E.L. DISEASE - POLICY LIMIT $ 1000000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Water Street Bridge Project C\TY RECORDER'S COpy
CERTIFICATE HOLDER
CANCELLATION
CITYAS2 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
City of Ashl~nd
20 E. Main Street
Ashland OR 97520
ACORD 25 (2001/08)
@ACORD CORPORATION 1988
'-IT'
ACORD~
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYV)
MAR U-l 01 11 07
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Protectors Insurance, LLC
Pilot Rock Ins Agency LLC (CA)
PO Box 4669
Medford OR 97501
Phone:541-773-5358 Fax:541-772-1906
INSURED
Marquess & Associates Inc
PO Box 490
Medford OR 97501
INSURERS AFFORDING COVERAGE
INSURER A: SAIF Co oration
INSURER B: Ma land Casual t
INSURER C:
INSURER D:
INSURER E:
NAIC#
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 CONDIT10N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSU~e:GOU NTS PAV'-C,
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION . .. .".
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSRC POLICY NUMBER P_qLJ!:1Y.~fFEg~E P!:?~LC_Y.!':.~PIRAT~~N LIMITS
TYPE OF INSURANCE DATE iMM/DDIYY DATE' (MM/DDIYY
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
B X X COMMERCIAL GENERAL LIABILITY PAS00487480 01/03/07 01/03/08 PREMISES (E~~~~~r~nce) $1,000,000
- ~ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000
PERSONAL & ADV INJURY $1,000,000
r--
X See Other GENERAL AGGREGATE $ 2,000,000
f--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
n n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
f--
B -.!.. ANY AUTO PAS00487480 01/03/07 01/03/08 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY' AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
B !J OCCUR D CLAIMS MADE PAS00487480 01/03/07 01/03/08 AGGREGATE $1,000,000
$
-a DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND I TORY LIMITS I IUJ~-
A EMPLOYERS' LIABILITY 913785 01/01/07 01/01/08 E.L. EACH ACCIDENT $ 1000000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1000000
~~EM.i.spW(M~~~~s below E.L. DISEASE - POLICY LIMIT $ 1000000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
STREET IMPROVEMENT PROJECT # 2005-34
CERTIFICATE HOLDER
CANCELLATION
City of Ashland
20 E. Main Street
Ashland OR 97520
CITYAS2 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
ACORD 25 (2001/08)
@)ACORD CORPORATION 1988
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