HomeMy WebLinkAboutInsurance Certificate: Brotherton Pipeline (2)
ACORD..
CERTIFICA 1;
illlTY INSURANCE ~'isIRo~I 06 06 08
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
S 20Q8 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Hart Insurance
P. O. Box 1240
Grants Pass OR 97528
Phone:541-479-5521 Fax:541-
INSURED
JUN
SURERS AFFORDING COVERAGE
Travelers Indemnity Co.
Brotherton Pipeline, Inc.
Brotherton Co~orat1on
11 South Frontage Road
Gold Hill OR 97525
COVERAGES
INSURER B:
INSURER C.
INSURER D
INSURER E:
Travelers ~roperty Casualty CO
SAIF CORP
NAIC#
10647
10647
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"""" NSR[ TYPE OF INSURANCE POLICY NUMBER b~~~1MMlDDIY'i) P8k~YrMMlbDNY)n LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A ~'jMERCIAl GENERAl LIABILITY DTC0526D9764IND07 06/10/08 06/10/09 Uf'\lVll-\~c. ~ u _t(crll,t:u $ 300,000
PREMISES (Ea occurence)
CLAiMS tv'ADE ~ OCCUR --
MED EXP (Anyone person) $10,000
PERSONAL & f.JJV INJURY $ 1,000,000
GENERAL AGGREGATE $2,000,000
GE,\j'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1,000,000
B X ANY AUTO DT810526D9764TIL07 06/10/08 06/10/09 (Ea accident)
-
ALL OWNED AUTOS BODIL Y INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODIL Y INJURY
- (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~- ANY AUTO OTHER THAN EA ACC $
I AUTO ONL Y AGG $
i EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $2,000,000
B ~ OCCUR D CLAIMS MADE DTSMCUP526D9764TILC 7 06/10/08 06/10/09 AGGREGATE $2,000,000
$
~ DEDlCTlBlE $
X RETENTION $10000 $
WORKERS COMPENSATION AND X ITO'R\ ti~I'-rs T IVEFr
C EMPLOYERS' LIABILITY 810614 10/01/07 10/01/08 EL EACH ACCIDENT $ 500000
ANY PROPRIETORIPARTNERlEXECUTIVE
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500000
If yes. describe under EL DISEASE - POLICY LIMIT $ 500000
SPECIAL PROVISIONS below
OTHER
OESCRIPTIONOF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
CITYASH
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, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Michel" ''x.A.
}L0
L}2-.
@ AC RD CORPORATION 1988
City of Ashland
Public Works Dept.
20 E. Main Street
Ashland OR 97520
ACORD 25 (2001108)