HomeMy WebLinkAboutInsurance Certificate: Mountain View Paving
CITY RECORDER
ACORDTM CERTIFICA TE OF LIABILITY INSURANCE I DATE(MMlDDlYYYY)
8/14/2008
PRODUCER (541)485-6633 FAX: (541)485-3946 THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
Beecher Carlson Insurance Agency LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
59 E 11th Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO Box 70206
Eugene OR 97401 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: North Pacific Insurance 23892
Mountain View Paving Ine INSURER B: SAIF Corporation
2560 E Main St:.reet:. INSURER c:
INSURER D:
Ashland OR 97520 INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTV\llTHSTANDING ANY
REQUIREMENT, TERM OR CONDlllON 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 CONDI1l0NS OF SUCH POliCIES.
a..... .......... ,-- UMITS SHOWN MAY - RFF cc:nlll"'c:n BY PAID CLAIMS.
INSR AOO'L ~~1:~~&!)Y'r ~k!flr~r.Cb~N LIMITS
LTR INSRrl TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
,.-- ~~~~J9~~ir~nce)
X COMMERCIAL GENERAL LIABILITY $ 100,000
A I CLAIMS MADE ~ OCCUR 006154211 9/25/2008 9/25/2009 $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
I---
- GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
Xl POLICY n ~8T n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
- $
X ANY AUTO (Ea accident)
- 9/25/2009
A ALL UV\lNl:.U AU I U~ C081!54211 9/25/2008 BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
- HIRED AUTOS BODILY INJURY $
NON-O\M\JED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN I;A ACC $
AUTO ONLY: AGG $
EXCESStUMBRELLA LIABILITY _.~. $ 1,000,000
~ OCCUR D CLAIMS MADE AGGREGATE $ 1,000,000
$
A ~ Ot::""DUCTIBLE 006154211 9/25/200B 9/25/2009 $
X RETENTION S 10 000 is
B WORKERS COMPENSATION AND X I T~~~JNs I IO~~-
EMPLOYERS' LIABILITY 500,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? 496578 10/1/2008 10/1/2009 E.L. DISEASE - EA EMPLOYEE $ 500,000
If yes, describe under 500,000
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLESlEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: Ashland Airport
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Ci ty of Ashland EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
90 N. Mountain 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
Ashland, OR 97520 -
FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ;It, A~
M Godfrey, CIC/SUENOA '7Y/, 1
ACORD 26 (2001/08)
INS02& (0108).08a
@ ACORD CORPORATION 1888
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