HomeMy WebLinkAboutInsurance Certificate: Pump Pipe & Tank Services
ACORD". CERTIFICA TE OF LIABILITY INSURANCE OP 10 C1 I DATE (MM/DDIYYYY)
PUMPP-1 10/28/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Monroe & Monroe Insurance Agen HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2921 Galleria Dr., Suite 102 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Arlington TX 76011 I
,
Phone: 817-640-5035 Fax: 817-640-0131 ! INSURERS AFFORDING COVERAGE i NAIC#
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INSURED I INSURER A: ~d-Continent Casualty Co. i
~---_._--- m
INSURER B: i
Pump PiEe & Tank Services .
Robert McHenry INSURER C:
Box 146 INSURER D:
Talent OR 97540 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.
TYPE OF INSURANCE POLICY NUMBER
.. GENERAL LIABILITY
f---.--.---
'4 CO~MERCIALGENE~LLlABILlTY 04GL737528
I.-::i-::-j CLAIMS MADE lliJ OCCUR
Ix I Pollution Liab
~ Professional Liab
\ GEN'L AGGREGATE LIMIT APPLIES PER:
I ~r8T II. LOC
AUTOMOBILE LIABILITY
I ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
LIMITS
A
11/15/08
. EACH OCCURRENCE
I DAMAGI:: I U KI::N II::D
11/15/09 L PREMISES (Ea occurence)
MED EXP (Anyone person)
.$1,000,000_
m__~!OO, 000
$ 0
-t ---.---------------------- -
. PERSONAL & ADV INJURY $ 1,000,000
rENERAL AGGREGATE r $ 2 , 000 , 000-----
: PRODUCTS - COMP/OP AGG \1 $ 2,000,000
I
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
I PROPERTY DAMAGE [$
(Per accident)
EXCESS/UMBRELLA LIABILITY
OCCUR 0 CLAIMS MADE
AUTO ONLY - EA ACCIDENT $
. OTHER THAN ~ $
AUTO ONLY: AGG I $
EACH OCCURRENCE
AGGREGATE
I
I
1$
---_.- ----_.."--. --------~------_._._.~._--------~_..._...__._-
GARAGE LIABILITY
ANY AUTO
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
A I Equipment Floater 04IM30876 11/15/081 11/15/09
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
E.L. DISEASE - EA EMPLOYEEI $
E.L. DISEASE - POLICY LIMIT I $
i
Owned Equ
4,900
CERTIFICATE HOLDER
CANCELLATION
CASHLAN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
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 REPRESE
@ ACORD CORP
TION 1988
Ci ty of Ashland
20 E. Main Street
Ashland OR 97520
ACORD 25 (2001/08)