HomeMy WebLinkAboutInsurance Certificate: Potelco
A CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DOIYY)
07/24/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
JOHN L. WORTHAM & SON, L.P. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. BOX 1388 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
HOUSTON, TEXAS 77251-1388 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
071555-1450-14 jea - Iwright INSURERS AFFORDING COVERAGE
INSURED -- INSURER A: Old Republic Insurance Company
POTELCo-, 'INC. INSURER B: AEGIS/Assoc. Electric & Gas Ins Serv
14103 STEWART ROAD
SUMNER, WA 98390 INSURER C:
INSURER 0:
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~: TYPE OF INSURANCE POLICY NUMBER PRH~Y EFFECTIVE P~~$J' EXPIRATION LIMITS
A ~NERAL LIABILITY MWZY57984 08/01/2008 08/01/2009 EACH OCCURRENCE $ 3,000,000
t/ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 1,000,000
1 CLAIMS MADE W OCCUR MED EXP tAnyone person) $ NOT APPLICABLE
i-- PERSONAL & ADV INJURY $ 3,000,000
~ GENERAL AGGREGATE $ 3,000,000
~'L AGGRM LIMIT APnS PER: PRODUCTS.COM~OPAGG $ 3,000,000
t/ POLICY ~~RT LOC
A ~TOMOBILE LIABILITY MWTB20228 08/01/2008 08/01/2009 COMBINED SINGLE LIMIT 3,000,000
(Ea accident) $
- ANY AUTO
~ ALL OWNED AUTOS BODILY INJURY
(Per person) $
'I--- SCHEDULED AUTOS
~ HIRED AUTOS BODIL Y,INJURY
$
L NON-owNED AUTOS (Per accident)
--- PROPERTY DAMAGE $
(Per accident)
RE UAmUTI AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
B EXCESS LIABILITY X2059A1A08 RETRO DATE 8/1/2002 08/01/2008 08/01/2009 EACH OCCURRENCE $ 5,000,000
U OCCUR 0 CLAIMS MADE AGGREGATE $ 5,000,000
$
R DEDUenBLE $
RETENTION $ $
A WORKERS COMPENSATION AND MWC11564900 08/01/2008 08/01/2009 t/ rT~~i~#~ 1 TOJ~. s
EMPLOYERS' LIABILITY $ 1,000,000
E.L EACH ACCIDENT
E.L DISEASE. EA EMPLOYE $ 1,000,000
E.L DISEASE. POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: ALL OPERATIONS
GENERAL LIABILITY AND AUTO LIABILITY POLICIES INCLUDE THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND
EMPLOYEES AS AN ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN C(~"i'Y~ re61=iESPECTS LIABILITY ARISING OUT OF
NAMED INSURED'S WORK FOR ADDITIONAL INSURED. . j. .DER
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION (SEE BELOW & PAGE 2)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
THE CITY OF ASHLAND, OREGON ANY KIND UPON THE ISSUER, ITS AGENTS OR REPRESENTATIVES,
ATTN: KARl ANN OLSON
90 N. MOUNTAIN AVE. ~T'1~~ RIrE~NTATI~Uat t. .
ASHLAND, OR 97520
I ....,."., .... ......\:'
ACORD 25-S (7/97) Page 1 of 2 , ACORD CORPORATION 1988