HomeMy WebLinkAboutInsurance Certificate: Ashland Construction
ACORD.M
CERTIFICATE OF LIABILITY INSURANCE
OP 10 AS I DATE (MM/DDNYYY)
9S0COPU 03/16/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOt
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
PRODUCER
Hart Insurance
3389 Crater Lake Hwy
Medford OR 97504
Phone: 541-779-4232
INSURED
Fax:541-772-3963
INSURERS AFFORDING COVERAGE
NAIC#
Ashland Consrtuction, Inc.
DBA: . Southern Oreqon Concrete
Pump~nq
102 Pleasant View
Talent OR 97540
INSURER A
INSURER B
INSURER C
INSURER D
INSURER E
Employers Mutual casualty Co.
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.
LTR NSRC TYPE OF INSURANCE POLICY NUMBER PD<i~~M~"DDNyr P~k~1Y(~~b'15'N~~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A X COMMERCIAL GENERAL LIABILITY 3X85671 03/21/09 03/21/10 U/"\JVI,"""C I U KeN I eu $ 100,000
- o CLAIMS MADE ~ OCCUR PREMISES (Ea occurence)
- MED EXP (Anyone person) $10,000
PERSONAL & ADV INJURY $1,000,000
-
GENERAL AGGREGATE $2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000
Xl n PRO- nLOC
X POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $1,000,000
A ~ ANY AUTO 3X85671 03/21/09 03/21/10 (Ea accident)
ALL OWNED AUTOS BODIL Y INJURY
- (Per person) $
SCHEDULED AUTOS
I--
HIRED AUTOS BODIL Y INJURY
f-- (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONL Y - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND IT~R\tll~~~ I IUE~-
EMPLOYERS' LIABILITY EL EACH ACCIDENT $
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If yes, descnbe under EL DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
O~ER
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: Verification of Insurance
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF ~E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, ~E ISSUING INSlRER WILL ENDEAVOR TO MAIL 10 DAYS 'MITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO ~E LEFT, BUT FAILURE TO DO SO SHALL
city of Ashland IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON ~E INSURER, ITS AGENTS OR
20 E Main Street REPRESENTATIVES.
Ashland OR 97520 AUTHORIZED REPRESENTATIVE
Glenn Johannes
ACORD 25 (2001/08)
@ACORD CORPORATION 1