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ACORQ. CERTIFICA TE OF LIABILITY INSURANCE T DATE (MM/DDIYYYY)
04/26/2007
PRODUCER (541)687-1117 FAX (541)342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ward Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 10167 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Eugene, OR 97440
Rob Harvey INSURERS AFFORDING COVERAGE NAIC#
INSURED Bergeson-Boese & Assoc i ates I nc INSURER A: Hudson Specialty Ins Co
DBA: Pacific Northwest Dri II ing INSURER B: Nationwide Mutual Ins Company 23787
32986 Roberts Court INSURER C: SAIF
COburg, OR 97408 INSURER D:
INSURER E:
COVFRAr.:E~
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 DD' TYPE OF INSURANCE POLICY NUMBER ~.u~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY FEC61 06785 04/3012007 04/30/2008 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY ~~~~9.~ro RENTED $ 50,000
= =:J CLAIMS MADE [I] OCCUR MED EXP (Anyone person) $ 5,OOe
A PERSONAL & ADV INJURY $ 1,000,000
- 2,OOO,OOC
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP~PAGG $ 2,000,000
h .nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY ACP7531541172 04/3012007 04/30/2008 COMBINED SINGLE LIMIT
7 ANY AUTO $
(Ea accident) 1,000,000
I--
ALL OWNED AUTOS BODILY INJURY
I-- (Per person) $
SCHEDULED AUTOS
B X
HIRED AUTOS BODILY INJURY
I-- (Per accident) $
X NON-OWNED AUTOS
I--
I-- PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
~ESSlUMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 473858 01/0112007 01/01/2008 rT~~T~J~-;,1 IOJ~-
EMPLOYERS' LIABILITY E.I.. EACH ACCIDENT $ 1,000,000
C ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes. describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000
SPECIAL PROVISIONS below
p~~t'lJT I ON L I AB FEC6106785 04/3012007 04/30/2008 LIMIT: $1,000,000
A PROFESSIONAL LIAB FEC6106785 04/3012007 04/30/2008 LIMIT: $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ADDITIONAL INSUREDS IF REQUIRED BY
HE CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE ADDED AS
NRITTEN CONTRACT
CERTIFICATE HOLDER
CANCELLATION
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,
CITY OF ASHLAND BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
20 E MAIN STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE I~ .'
'7/4/,.;) (r f1t~.
Rob Harvev/CARSON <.'.-.- )
ACORD 25 (2001/08)
@ACORDCORPORATION 1988