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Home My WebLink AboutF.D. Thomas AC:JRD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMfDD1YYYY) 09/27/2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Woodruff-Sawyer Oregon, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 100 I SW 5th A venue, Suite 500 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Portland, OR 97204 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (503) 416-7180 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: SAIF Corporation 36196 F.D. Thomas, Inc. INSURER B: POBox 4663 Medford, OR 9750 I INSURER c: INSURER D: 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 DO' ~p.n. POLICY EFFECTIVE Pg~!f",Y EXPIRATION POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ t-- PREMISES '1E~~~uL~nce COMMERCIAL GENERAL LIABILITY $ I GLAiiviS MADe D OCCUR. MED EXP {Anyone person) $ ~ PERSONAL & ADV INJURY $ t-- GENERAL AGGREGATE $ n'l AGGrlE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ POliCY ~~g- lOC ~TOMOBILE LIABILITY COMBINED SINGLE liMIT $ ANY AUTO (Ea accident) f-- I- All OWNED AUTOS BODilY INJURY {Per person) $ f-- SCHEDULED AUTOS f-- HIRED AUTOS BODilY INJURY (Peraccidenl) $ - NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY; AGG $ pESSlUMBRELLALlABILlTY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND 812175 1 % 1/2007 1 % 1/2008 X I T'1,%,;I~TI~s I IO~~. EMPLOYERS' L1ABlLlTY 500 000 E.l. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ 500 000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500 000 SPECIAL PROVISIONS below OTHER $ $ $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS All Operations Operations of the Named Insured subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION 10 Day Notice for Non-Payment of Premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITIEN Service Center NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 90 N. Mountain Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ashland, OR 97520 REPRESENTATIVES. I I LOAN #: AUTHORIZED REPRESENTATIVE ~..tJ.~ ~ .t..y.( . r ~ ACORD 25 (2001/08) 10 #: @ACORDCORPORATION1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108) ACORD... CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 12/13/2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Woodruff-Sawyer Oregon, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1001 SW 5th Avenue, Suite 500 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Portland, OR 97204 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (503) 416-7180 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: American Zurich Insurance Company 40142 F.D. Thomas, Inc. INSURER B: POBox 4663 Medford, OR 97501 INSURER c: 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. I~~: r..~~: TYPE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A ~NERAL LIABILITY CP0373910202 12/31/2007 12/31/2008 EACH OCCURRENCE $ I 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES lEa occurence\ $ 300 000 I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10 000 X Stop Gap - $1,000,000 PERSONAL & ADV INJURY $ 1 000 000 - - GENERAL AGGREGATE $ 2 000 000 ~'L AGGREGATE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ 2 000 000 POLICY fXl ~f-PT LOC A ~TOMOBILE LIABILITY CP0373910202 12/31/2007 12/31/2008 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO (Ea accident) - ALL OWNED AUTOS BODILY INJURY ~ $ SCHEDULED AUTOS (Per person) i-- X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ o OCCUR . 0 CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I WC STATU- I !OJ~- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 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 All Operations Operations ofthe Named Insured subject to policy terms and conditions CITY RECORDER CERTIFICATE HOLDER CANCELLATION 10 Day Notice for Non-Payment of Premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Service Center NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 90 N. Mountain Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ashland, OR 97520 REPRESENTATIVES. LOAN #: AUTHORIZED REPRESENTATIVE ~ 46' J I _t",~ r, ACORD 25 (2001/08) 10 #: @ACORD CORPORATION 1988