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A CORD,_ CERTIFICATE OF LIABILITY INSURANCE DATE (MMOOIYYYY)
4/13/2009
PRODUCER (541) 172-1111 FAX: (541) 112-3185 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICA TE
Beecher CarJ.son Insurance Agency LLC HOLDER. THIS CERllFICATE DOES NOT AMENDE EXTEND OR
101 Murphy ReI AL TER THE COVERAGE AFFORDED BY THE POLlel S BELOW.
Medford OR 91504 INSURERS AFFORDING COVERAGE NAICft
INSURED INS~RERA Fbil.adcl.phi.a Insurance
Soda Inc INSURER 6:
604 South 2nd st INSUP.EP c
INSI,RFFi[)
Central. Point OR 91502 INSUFiEP E
C V S
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOO INDICATED. NOTWITHSTANDING ANY
REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTI-lER DOCUMENT WITH RESPECT TO \MilCH 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.
A~.,"oG .TO' 'MOT< SHO'^'" UdV "AVO RooN om,co" RY oAm OIA"<
II~~: ,~~~~ TYPE OF INSURANCE POLlCY NUMBER ~;+~~~~~~~~ Pg~~JI~:g~~~N LIMITS
~NERAL UABILlTt EACH OC:::URREN:::E , 1,000,000
~ pMl:HCLAJ...lH:r-,e:IIAL LIAI:lLlI Y ~~l~Hc;Jf~~,~~tlDp.tlOl' , 100,000
A - CL~MS MADE ~ '.:JCCUR PHPK3528!}2 10/4/2008 ~O/4/:l009 MEn FXF (AIl'lQl"lo'l U"'I"~(;") , 5,000
- PERSOri/J... 8. lIDV I~J,LR.( I EXCLUDED
- GEN[~Al AGGj:\[;:GATE , 2,000,000
~'L AGGREnE LIMn nESPER PP,nllrT<:; _ rr-M"np Af',r:. , 2 000 000
X FOLICY f'[<81- LOC
~TOMOBILELlABILlTY COMAII'IED SINGLE LIMIT ,
(::f.fl,;c:irlmll
- ;WYNJTO
- '" OV\i1\JFn.t.llTr:s 8001_ Y INJJRY
f::>crpop::on) I
- SCHEDULEDA\JTOS
- HIPEDAUTOS BOOI_YINJJRY ,
(?Hacdd~nl)
- tlNt OWIED !\UTOS c
- PR::JPERTY D/lNAGE $
e~, "r.f;,J~nl)
~RAGE LIABILITY , AUTO UN_V - ~ACCIDE'H ,
,.\NYA,UTO aT -lER THfIN EAACC I~
A0TOOii'_'l'" AGG ,
=:JESS/UMBRELLA LIII.BIL1TY .' ~ RPI=~rF I
OCCUR 0 CLAIMS MJI.OE .t.r.r.RF(;AT- $
I
~ DEDUCTiBlE $
RETE~JT OtJ , ,
V\IORkE"RS COMPF.NSATION AND IT~Yi$T.rsY<, I IO/J;i
FMPI.CYFR~' UII.RII,ITY
.llNY.PI"'OPI;,'IETOR,PAAT.'IlERIE-XECLTT/IIE E.L. E.A,Ci-c ACCIDE\jT I
OFFIC=PIMFMnFR FXr.l1 Jnrm E.L DI::EA3::- EA "'MF1..0tEE $
If >"''''_ (",~r;d:1F l.nrl~r
~PI"C1.t.1 :>PI1VIJ'.:I()NS h~ln"" ::: L DISEASE - POliCY LIMn ,
OlHER
,
DESCRIPTION OF OPERATIONS^-OCATIONSNEHICLESIEXCLUSIONS ADDEO BY ENDORSEMENTISPECIAL PROVISIONS
Verification of in,"urilnce.
/
CERllFICATE HOLDER
CANCELLATION
SHOULD ANY OF THe; ABOVE DESCRIBED POLICIES ., CANCELLED BEFORE THE
City of Ashland F;XPIRATlnN IlATF: n"II:::RFnl'", THI' ISSUING INSURER WILL ENnFAVOR TO MA~_
Attn: Bryn Morrison 10 L1AYS WKI1TEN NOIICE TO rHE CJ::Rllf-ICAIE HULU8( NAMf::U fU 1HE L1:rT, ~ur
20 E Main street -
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY I(INO UPON THE
Ashland, OR 97520
INSURER, ITS AGEtITS OR REPRESE~rrAnVES.
II.UTHORIZEO REPRESENTATIVE '-,.:; --;? //0
lyn:1. Zt:rmuh:"e-/LY;-iNZl" ;.",,\ Y/CA.. ~~"""~~4ii<"~
ACORD 25 (2001/08)
INS025 (0100).00,:,
@ACORDCORPORATION1988
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