HomeMy WebLinkAboutInsurance Certificate: Newco
CITY RECORDER
ACORDm CERTIFICATE OF LIABILITY INSURANCE I DATE (MMJDDfYYYY)
10/31/2008
PRODUCER (206) 838-9077 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Services, Inc. ONLY AND CONFERS, NO RIGHTS UPON THE CERTIFICATE
DML Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4005 20th Ave W Ste 132 ALTER THE COVERAGE AFFORDED 8Y THE POliCIES BELOW.
Seattle WA 98199- INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: American Int'l Soecialtv
Neweor Inc. dba Cascade Columbia Distribution; INSURER B: Commerce and Industrv
at al INSURER c:American Intll Scecialtv
6900 Fox Ave S INSURER D
-Seattle WA 98108- 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 ADD'L. POLICY EFFECTIVE Pg~!fJI~~bRC'>>~N
LTR INSRD TYPE OF INSURANCE POLlCY NUMBER DATE (MM/DDfYY) LIMITS
,A, ~NERAL. L.IABILlTY EG2674220 10/31/2008 10/31/2009 EACH OCCURRENCE , 1,000,000
X COMMERCIAL GENERAL LIABILITY ~~~~~~J9~~~~~~ence $ 100,000
I CLAIMS MADE ~ OCCUR / / / / MED EXP IAnv one nerson\ , 25,000
~ Pollution Liability PERSONAL & ADV INJURY , 1,000,000
~ Vendors Liability / / / / GENERAL AGGREGATE , 2,000,000
~.~ AGG~EnE LIMIT A~ES PER: PRODUCTS. COMP/OP AGG , 2,000,000
POLICY m~i X LOC / / / /
B ~TOMOBIL.E L1ABIL.ITY CA7665964 10/31/2008 10/31/2009 COMBINED SINGLE LIMIT 1,000,000
(Eaaccident) ,
~ ANY AUTO
- ALL OW\lED AUTOS / / / / BODILY INJURY
(Per person) ,
SCHEDULED AUTOS
- / / ,
-- HIRED AUTOS / / BODILY INJURY
{Per accident) '.
- NON-OVvNED AUTOS
/ / '. / / PROPERTY DAMAGE
'. {Per accident) ,
~~GE LIABILITY AUTO ONLY - EA ACCIDENT ,
ANY AUTO / / / / OTHER THAN EAACC $
AUTO ONLY: AGG ,
C EXCESS/UMBRELLA LIABILITY EAU2679823 10/31/2008 10/31/2009 EACH OCCURRENCE , 10,000,000
iJ OCCUR 0 CLAIMS MADE AGGREGATE , 10,000,000
c
,
;1 DEDUCTIBLE / / / / ,
X RETENTION $ 10,000 ,
WORKERS COMPENSATION AND / / / / I T~-rIfJNs I 10TH,
'R
EMPL.OYERS. LIABILITY
ANY PROPH1ETORlPARTNEHfEXECU1IVE - EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? / / / / EL DISEASE. EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $
B OTHER Auto Physical Damage CA7665964 10/31/2008 10/31/2009 Comprehensive Oed 1,000
/ / / / Collision Deductible 1,000
/ / / /
DESCRIPTION OF OPERATIONSfLOCATlONSlVEHICL.ESlEXCL.USIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
(541) 488-5354 (541) 488-5320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Kari Olson - Purchasing EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL.
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOL.DER NAMED TO TH.E LEFT, BUT
-
City of AShland FAILURE TO DO SO SHALL IMPOSE NO OBL.IGATlON OR LIABILITY OF ANY KIND UPON THE
90'N Mountain Avenue INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~~~CJ -
Asland OR 97520-
ACORD 25 (2001/08)
~TM~ INS025 (0108).05
<>ACORDCORPORATION 1988
ELECTRONIC LASER FORMS, INC. - (800)327-0545
. Page 1 012