HomeMy WebLinkAboutInsurance Certificate: Southern Oregon Concrete Plumbing
A CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY)
3/11/2008
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 Trinity Universal of 15954
Ashland Construction Inc, INSURER B:
DBA: Southern Oregon Concrete Pumping INSURER C:
102 Pleasant View INSURER D:
Talent OR 97540 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.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L Pg.t+~~~~~gg~~~ Pg~f~I~~~t~\gN LIMITS
TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
- ~~~~~~J?E~~~~~~ncel
X COMMERCIAL GENERAL LIABILITY $ 100,000
A I CLAIMS MADE [!] OCCUR CAP2502463 3/21/2008 3/21/2009 MED EXP IAnv one oerson) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
-
GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREGATE LIMIT AFlES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
Xl .n PRO-
X POLICY ',,,rT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
- (Ea acc,dent) $
~ ANY AUTO
A ALL OWNED AUTOS CAP2502463 3/21/2008 3/21/2009 BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
- HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY $
tJ OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETE'NT!ON $ $ --
WORKERS COMPENSATION AND I T~~$'ItJNs I IOJ~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OE'FICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
This form is subject to policy terms, conditions, and exclusions.
CERTIFICATE HOLDER
CANCELLATION
City of Ashland
20 E Main Street
Ashland, OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 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 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
f~~.--
ACORD 25 (2001/08)
INS025 (0108).08a
Mike Mastroni/PAUORT
@ACORD CORPORATION 1988
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