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A CORDTN CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY)
03/13/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION
MARSH USA INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
111 SW COLUMBIA, STE 500 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PORTLAND, OR 97201 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
900810-PG-GA- PM INSURERS AFFORDING COVERAGE NAlC#
INSURED INSURER A Zurich American I nsurance Co 16535
PAPE' MACHINERY, INC.
cia THE PAPE' GROUP, INC. INSURER B
PO BOX 407 INSURER C:
EUGENE, OR 97440
INSURER D'
I.
INSURER E: I
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.
NSR ADD'L TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE POUCY EXPIRATION UMITS
LTR INSRC DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL UABIUTY EACH OCCURRENCE ,$ 1 000 000
A GL03784857-03 12/01/08 12/01/09 DAMAGE TO RENTED $ 100,000
~MERCIAl GENERAlllABUY PREMISES(Ea occurence)
CLAJMS MADE 0 OCCUR MED EXP (Anyone person) $ 5,000
X WASHINGTON STOP GAP- PERSONAL &ADV INJURY $ 1,000,000
$1 ,000,000 LIMIT GENERAL AGGREGATE $ 5,000,000
GENERAL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG$ 2,000,000
II POLICY n PRO- n
JECT LOC
A AUTOMOBILE L1ABIUTY BAP378 4856-03 12/01/08 12/01/09 COMBINED SINGLE LIMIT
f----- (Ea accident) $ 2,000,000
X ANY AUTO
f.- ALL OWNED AUTOS BODIL Y INJURY $
f----- (Per person)
SCHEDULED AUTOS
-
X HIRED AUTOS BODJL Y INJURY $
- (Per accident)
X NON-OWNED AUTOS
f--- -- ......-.-.
PROPERTY DAMAGE $
f--- (Per accident)
GARAGE UABIUTY AUTO ONLY - EAACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: $
AGG
EXCESS/UMBRELLA L1ABI UTY EACH OCCURRENCE $
0 OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ ~
WORKERS COMPENSATION AND IT~~~i ~I~~ I 10J~-
EMPLOYERS' UABIUTY
:=.L. EACH ACCIDENT $
ANY PROP R IETOR/P ARTNER/EXECUTIVE ~L DISEASE - EA EMPLOYEE $
OFFICER/MEMBER EXCLUDED?
If yes, describe under .L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY EN DORSEMENTISPECIAL PROVISIONS
RE: THE CITY OF ASHLAND, OREGON, AND ITS ELECTED OFFICIALS, OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS
WHEN REQUIRED BY WRITTEN AGREEMENT OR CONTRACT AS RESPECTS TO OPERATIONS OF THE NAMED INSURED.
CERTIFICATE HOLDER
SEA-001326042-0 1
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEUED BEFORE THE
CITY OF ASHLAND EXPIRATION DATE THEREOF, THE ISSUING INSURER WIll. ENDEAVOR TO MAIL
20 EAST MAl N STREET 30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ASHLAND, OR 97520 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND
UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
A~lJtl~~~i9~\'~c~ENTATIVE ~'fA A.Whi~
Elizabeth A. Whiting
ACORD 25 (2001/08)
o ACORD CORPORATION 1988