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Home My WebLink AboutSODA Inc ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) 11/29/2007 PRODUCER (541) 772-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JBL&K Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 707 Murphy Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Capi tol Specialty Soda Inc INSURER B: 604 South 2nd St INSURER C: INSURER D: Central Point OR 97502 INSURER 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. 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I~!,~ A~9.:~ POLICY EFFECTIVE POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER DATE IMMIDD!YY\ DATE (MMIDD!YYl GENERAL LIABILITY RRENCE $ 1,000,000 - X COMMERCIAL GENERAL LIABILITY ~~~~~U9E~~~J~~enCe\ $ 100,000 A l CLAIMS MADE ~ OCCUR CS00353l97 10/4/2007 10/4/2008 MED EXP IAnv one oerson' $ 5,000 PFR""NAI, & ADV IN "'RY $ EXCLUDED - - GENERAL AGGREGATE $ 2,000,000 ~'L AGGREnE LIMIT APPLIES PER PROnllr.T" - r.OMP/OP N'" $ 2,000,000 ~~T n X POLICY LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) - - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - - HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN FAAr.r. $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY , 'DDC.'''C $ :=J OCCUR D CLAIMS MADE AGGREGATE $ $ rl DEDUCTIBLE $ RETENTION ~ 1$ WORKERS COMPENSATION AND I WC STATU- I TOJ,tI- EMPLOYERS' LIABILITY ANY PROPRIETORlPARTNER/EXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ ~~~61~~s~~b~~~~~~s below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ***********VERIFICATION OF INSURANCE************* This form is subject to policy terms, conditions, and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Attn: Lee Tuneberg Finance Director 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 20 E Main Street - FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Ashland, OR 97520 INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~fiX- ~ Lynn Zurmuhle/LYNNZU ACORD 25 (2001/08) INS025 (0108).OBa @ ACORD CORPORATION 1988 Page 1 012 ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) 11/30/2007 PRODUCER Commercial Lines... 541-685-5300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ABD Insurance & Financial Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 355 Goodpasture Island Road, Suite 104 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Eugene, OR 97401 INSURERS AFFORDING COVERAGE NAIC# INSURED Soda Mountain Broadcasting, Inc. DBA: KDRV & KDKF INSURER A: Fireman's Fund Insurance Company 21873 PO Box 7009 INSURER B: INSURER C. INSURER D: Eugene, OR 97403 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. LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PJ>.k~~~,i~~~8,w\E p~~~J (~X:'~~N LIMITS A ~NERAL LIABILITY MZX80882474 12/01/2007 12/01/2008 EACH OCCURRENCE $ 1.000.000 X COMMERCIAL GENERAL LIABILITY ~~~~~H9E~~~J~~oneo \ $ 1.000,000 I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 20.000 PERSONAL & ADV INJURY $ 1.000.000 - GENERAL AGGREGATE $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 I nPRO- n POLICY JECT LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) I-- '-- ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) I-- '-- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I-- PROPERTY DAMAGE $ (Per accident) RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ OESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ $ ==i DEDUCTIBLE $ RETENTION $ -.--- -_..- ._----'--_.~. -.. $ WORKERS COMPENSATION AND I T'g~l ~~,;Ws I IOJ~- EMPLOYERS' LIABILITY $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 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/ VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Certificate holder is added as additional insured. CERTIFICATE HOLDER CANCELLATION Ten Day Notice for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Ashland Fiber Network City of Ashland NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 20 East Naub IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ashland, OR 97520 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ ~ ACORD 25 (2001/08) 1 of 2 92121 @ ACORD CORPORATION 1988