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Home My WebLink AboutInsurance Certificate: WHA Insurance ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM1DDIYYYY) 6/16/2008 PRODUCER (800)852-6140 FAX: (541)342-3786 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wilson-Heirgood Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2930 Chad Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 1421 Eugene OR 97440-1421 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Casual ty Ins. 29424 WHA INSURANCE AGENCY, INC. WHA INSURANCE INSURER B: Hartford Underwri ters 30104 PO BOX 1421 INSURER c: INSURER D: EUGENE OR 97440 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. I t:. LIMITS SHOWN MAV HAVF RFF fJ Q~nl Jr.Fn BY PAID r.1 AIM~ I~~: ADD'L P~Al{~~i:68,%E Pg~'W{if':'~~N LIMITS IN~Rn TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 r--- ~~~~~J?E~~~J~nce) COMMERCIAL GENERAL LIABILITY $ 300,000 A I CLAIMS MADE D OCCUR 52SBAPM9298 7/31/2008 7/31/2009 MED EXP (Anv one Derson) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 r--- GENERAL AGGREGATE $ 2,000,000 r--- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 rxl POLICY n ~~RT n LOC AUTOMOBILE L1ABILllY COMBINED SINGLE LIMIT 1,000,000 - (Ea accident) $ X ANY AUTO - B ALL OWNED AUTOS 52UECUS5685 7/31/2008 7/31/2009 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 $ ~ AN'( AUTO OTHER THAN F'A ACC $ AUTO ONLY: AGG $ EXCESS1UMBRELLA L1ABILllY EACH 1"'\1"'1"'1 IgQI=NCI= $ 1,000,000 ~ OCCUR D CLAIMS MADE AGGREGATE $ 1,000,000 $ A ~ DEDUCTIBLE 52SBAPM9298 7/31/2008 7/31/2009 $ X RETENTION $ 10, ClClO $ WORKERS COMPENSATION AND I T~~~IftlNs I IOJ~- 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 OPERATIONS1LOCATIONSNEHICLES1EXCLUSIONS ADDED BY ENDORSEMENT1SPECIAL PROVISIONS City of Ashland and its elected officials, officers and employees are listed as additional insureds in regards to liability. aiTV RECORDER 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 Purschaing Representative 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Attn: Kari Olson - 90 N Mountain Avenue 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 .c;;e. ---- ~- Laura Severs/LLS .... ACORD 25 (2001/08) INS025 (0108).08a @ ACORD CORPORATION 1988 Page 1 of 2 ADDITIONAL COVERAGES Ref # Description Coverage Code Form No. Edition Date Terrorism coverage TERR Limit 1 Limit 2 Limit 3 Deductible Amount Premium Ref # Coverage Code Form No. Edition Date EBLlA Limit 1 Limit 2 Limit 3 Deductible Amount Premium 1 ,000,000 2,000,000 Ref # Description Coverage Code Form No. Edition Date Uninsured motorist combined single limit UMCSL Limit 1 Limit 2 Limit 3 Deductible Amount Premium 1,000,000 Ref # Coverage Code Form No. Edition Date PIP Limit 1 Limit 2 Limit 3 Deductible Amount Premium 15,000 100 Ref # Description Coverage Code Form No. Edition Date Terrorism coverage TERR Limit 1 Limit 2 Limit 3 Deductible Amount Premium Ref # Coverage Code Form No. Edition Date CUMBR Limit 1 Limit 2 Limit 3 Deductible Amount Premium $400.00 Ref # Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Premium Ref # Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Premium Ref # Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Premium Ref # Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Premium Ref # Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Premium OFADTLCV Copyright 2001, AMS Services, Inc.