HomeMy WebLinkAboutInsurance Certificate: Cascade Employers Association
Certificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN
INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED.
This is to Certify that
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CASCADE EMPLOYERS ASSOCIATION INC. OF
CASCADE EMPLOYERS PREFERRED RISK GROUP
4068 HUDSON AVE NE
SALEM OR 97301-5142
11.1..1...1..11.11......11.1.1....11.1..1..1.1.11..1..1..1..11
Member ofI.iberty ~futllal Group
Liberty Centre
650 NE Holladay Street
PO Box 4555
Portland, OR 97208-4555
Tel: 503 239 5800
WNW. Ii bertynorthwest. com
is, at the date of the certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies)
is subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of any contract or other
document with respect to which this certificate may be issued.
TYPE OF POLICY
EXPIRATION
DATE
POLICY NUMBER
LIMITS OF LIABILITY
[]I WORKERS'
COMPENSATION
4/ 0 1/ 2009 WC4- 1 NC - 0 1 667 1
COVERAGE AFFORDED UNDER w.c. LAW
OF FOLLOWING STATES:
OR
COVERAGE AFFORDED UNDER w.c. LAW
OF FOLLOWING STATES:
EMPLOYERS LIABILITY LIMITS
EMPLOYERS LIABILITY LIMITS
Each Accident
Disease - policy limit
Disease - each employee
$500 ,000 Each Accident
$ 5 0 0 , 0 0 0 Disease - policy limit
$ 5 00 , 0 0 0 Disease - each employee
MARITIME COVERAGE - FOLLOWING STATES:
LIMIT OF L1AB. - MARITIME COVERAGE
GENERAL LIABILITY
General Aggregate
o Commercial General
Liability (Occurrence)
o
Products Com plOps Aggregate
$
$
$
$
$
$
Owner's and Contractors
Protective
Personal & Advertising Injury
Each Occurrence
Fire Damage (Anyone fire)
Medical Expense (Anyone person)
AUTOMOBILE LIABILITY
0 Any Auto
0 All Ovvned Autos
0 Scheduled Autos f .~
0 Hired Autos
0 Non-owned Autos
0 Garage Liability
CSL
$
$
$' .
$
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Bodily Injury (Per Person)
Bodily ffltufY (Pef AcGi6eflt}--
Property Damage
110 'j
1 ,1
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2008
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LOCATION(S) OF OPERATIONS & JOB # (IF APPLICABLE)
DESCRIPTION OF OPERATIONS
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CANCELLATION:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING
COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT
FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, OR
REPRESENTATIVES.
MAILED TO:
CITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520-1814
11.1..1...1.1.1...1.111......111..1..1111.1..1..1.111......111
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AUTHORIZED REPRESENT IVE
EFS 13 11/11/2008
DATE ISSUED
PORTLAND Underwriting
OFFICE
CERTIFA