HomeMy WebLinkAboutInsurance Certificate: Bob Harshman Transport & Excavation
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
12/10/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
TOM STANALAND INSURANCE AGCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
722 .Cardley Ave HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford, OR 97504
(541)779-5364 INSURERS AFFORDING COVERAGE NAIC#
INSURED BRUCE R. HARSHMAN INSURER A: FARMERS INSURANCE EXCHANGE
DBA BOB HARSHMAN TRANSPORT & EXCAVATION INSURER B:
460 ARNOS #73 INSURER C:
TALENT, OR 97540 INSURER D:
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.
INSR ~DD'L b~Y~rM~b5~YE P8k+~1~~~6~~WN
LTR NSRD TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
- ':'':'I\II''',~l:..
COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $
I CLAIMS MADE [] OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
I---
GENERAL AGGREGATE $
I---
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
n II PRO- IILOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
I--- $
ANY AUTO (Ea accident)
r--
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
X SCHEDULED AUTOS
- 604700405 12/05/08 12/05/09
A HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNEDAUTOS
'--
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==J ANY AUTO OTHER THAN EA ACC $
AUTOONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
-I OCCUR [] CLAIMS MADE AGGREGATE $
-'
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I WCSTATU- I 10IJ-I-
TORY LIMITS ER
EMPLOYERS' LIABILITY EL. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEI $
If yes, describe under EL. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
1987 PETERBILT CONVENTIONAL 377 1XPCDB9X5HD213624
1989 WESCO TRAILER 1WRFH3280KW893618
CERTIFICATE HOLDER
CITY OF ASHLAND
90 MOUNTAIN ST
ASHLAND OR 97520
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAi-L- 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 REPRESENTATIVE
I
ACORD 25{2001/08)
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.k? @ ACORD CORPORATION 1988
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