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Home My WebLink AboutAshland Sanitary & Recycling ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YY) 08/31/2007 PRlDUCER (503)692-1520 FAX (503)692-1299 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION KBI Insurance, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 888 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 18660 S.W. Boones Ferry Rd. Tualatin, OR 97062 INSURERS AFFORDING COVERAGE INSURED Ashland Sanitary & Recycling Service INSURER A NORTH PACIFIC INSURANCE COMPANY Valley View Landfill, Inc. dba: Valley View INSURER B SAIF CORPORATION Transfer Station INSURER C' 170 Oak St INSURER D' As~land, OR 97520 INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE:D 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 TYPE OF INSURANCE POLICY NUMBER Pgl+~~~~j6~1~~IE Pg~I(EY(~~~RD~~!gN LIMITS LTR GENERAL LIABILITY COl 170064 09/07/2007 09/07/2008 EACH OCCURRENCE S 1,000,00C f-- 100 , OO'C X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any olle fire) S f-- =:J CLAIMS MADE [K] OCCUR MED EXP (Anyone person) .. S 5,000 f-- -_.. A PERSONAL & ADV INJURY S 1,000,00C f-- 2,000,00C GENERAL AGGREGATE $ f-- ----~ 2,000,00C GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S II n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY ~01 170064 09/07/2007 09/07/2008 COMBINED SINGLE LIMIT f-- $ X ANY AUTO (Ea accident) 1,000,000 f-- ALL OWNED AUTOS BODIL Y INJURY - (Per person) S SCHEDULED AUTOS A - HIRED AUTOS BODIL Y INJURY - (Per accident) :;; NON-OWNED AUTOS - - PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S =1 ANY AUTO OTHER THAN EA ACC :;; I AUTO ONLY: AGG S ~ESS LIABILITY EACH OCCURRENCE :;; 1,000,00C ~ OCCUR 0 CLAIMS MADE 01 170064 09/07/2007 09/07/2008 AGGREGATE s 1,000,00C A s _.~---- ~ DEDUCTIBLE :;; X RETENTION S 10,00C S WORKERS COMPENSATION AND 930859 07/01/2007 07/01/2008 I TV6~~~~iNs I IUJ H ER EMPLOYERS' LIABILITY EL EACH ACCIDENT S 500,000 B E.L. DISEASE - EA EMPLOYEE 500,000 :;; r I ' F__I_ DISFASE - POLICY LIMIT , S 500,092 OTHER I I 1 I I RIESCRIPTION OF OPERATlONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS E: ASHLAND RECYCLING CENTER HE CITY OF ASHLAND IS ADDED AS ADDITIONAL INSURED PER FORM CG 32 61 10 05. CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CITY OF ASHLAND l BUT FAILURE TO MAIL SUC~)ALL IMPOSE NO OBLIGATION OR LIABILITY 20 EAST MAIN STREET OF ANY KIND UPON THE CO ANY, ITS AGENTS OR REPRESENTATIVES. ASHLAND, OR 97520 I AUTHORIZED REPRESENTAT\~. _~ 1!t1JU...... I \c _ 'JJO, ___ ACORD 25-S (7/97) @ACORD CORPORATION 1988 POLICY NUMBER C01 170064 COMMERCIAL GENERAL LIABILITY CG 32 61 1005 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OREGON ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS - SCHEDUl ED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): CITY OF ASHLAND Location(s) Of Covered Operations: ASH:LAND RECYCLING CENTER "--- Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused by your ongoing operations for the addi- tional insured( s) at the location( s) designated above and only to the extent that such "bodily in- jury", "property damage" or "personal and advertis- ing injury" is caused by your negligence or the neg- ligence of those performing operations on your behalf 8, With respect to the insurance afforded to these additional insureds, the following additional exclu- sion applies: This insurance does not apply to "boclily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. Page 1 of 1 CG 32 61 10 05 @ ISO Properties, Inc., 2005 o