HomeMy WebLinkAboutInsurance Certificate: Versatile Concrete
A CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
9/12/2008
PRODUCER (541)857-0679 FAX: (541)857-9883 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ashland Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
801 O'Hare Parkway, Ste 101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: SAIF Corporation
Versatile Concrete Construction, Inc. INSURER B:
PO Box 507 INSURER C:
2106 S. Pacific Hwy INSURER D:
Talent OR 97540 INSURER E:
,~c~
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 POLICY EFFECTIVE Pg~IW,~~~~N LIMITS
lTR i1NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD1YY)
GENERAL LIABILITY EACH OCCURRENCE $
- ~~~~~~9E~~J~~ence)
COMMERCIAL GENERAL LIABILITY $
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
r--
GENERAL AGGREGATE $
f--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGr. $
n nPRO- n
POLICY JEeT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I--- (Ea accident) $
r-- ANY AUTO
ALL OWNED AUTOS BODILY INJURY
r-- (Per person) $
SCHEDULED AUTOS
r--
- HIRED AUTOS BODILY INJURY $
NON-DWNED 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 EACH $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTiBlE $
RETENTION $ s
A WORKERS COMPENSATION AND I ~~~I~J~s I IOJ~-
EMPLOYERS' LIABILITY 500,000
ANY PROPRIETOR/PARTNER/EXECUTIVE ~- E.L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? 929007 4/1/2008 4/1/2009 E.L. DISEASE - EA EMPLOYEE $ 500,000
If yes. describe under E.L. DISEASE - POLICY LIMIT $ 500,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICA TE HOLDER
(541)488-5311
City of Ashland
20 E. Main St.
Ashland, OR 97520
CANCELLA TION
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
OR LIABILITY OF ANY KIND UPON THE
ACORD 25 (2001/08)
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