HomeMy WebLinkAboutInsurance Certificate: Cascade Employers Assoc of Pacific NW
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
I DATE
01- 14. - 2 00 9
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WR REED & CO/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
701053 P: (866)467-8730 F: (877) 905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO BOX 33015 INSURERS AFFORDING COVERAGE
SAN ANTONIO TX 78265
INSURED INSURER A: Hart ford Casualty Ins Co
CASCADE EMPLOYERS ASSOCIATION OF THE INSURER B:
PACIFIC NORTHWEST, INC. INSURER c:
4068 HUDSON AVE. N.E. INSURER D:
SALEM OR 97301 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 TYPE OF INSURANCE I POLICY NUMBER r:i\~rM~~~g~~~ ttgk~l/fAYpI,I~~m~ LIMITS
LTR
GENERALUAWlY I EACH OCCURRENCE $1,000,000
A - COMMERCIAL GENERAL LIABILITY 5 2 SBA PP3718 03/15/09 03/15/10 FIRE DAMAGE (Anyone fire) $1,000,000
I CLAIMS MADE lKJ OCCUR MED EXP (Anyone person) $10,000
~ General Liab PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2 , 000 , 000
I-- $2, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG
f--I II PRO I X I LOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
I--
A ANY AUTO 52 SBA PP3718 03/15/09 03/15/10 (Ea accident)
I--
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
X HIRED AUTOS BODILY INJURY
- $
X NON-OWNED AUTOS (Per accidentl
---:-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY I AUTO ONLY. EA ACCIDENT $
-
l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
. EACH OCCURRENCE $
EXCESS LIABILITY
~
o OCCUR U CLAIMS MADE AGGREGATE $
$
f--
l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I 'to? ST~~! I IOJ~-
TRYlIlS
EMPLCYERS'LlABlLITY E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE. POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Those usual to the Insured's Operations.
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
City of Ashland
20 E MAIN ST
ASHLAND, OR, 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I
EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) 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.
AUTHO
o
~IVE7~L~
e ACORD CORPORATION 1988
ACORD 25-5 (7/97)