HomeMy WebLinkAboutInsurance Certificate: Pathway Enterprises State Farm
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400 High Street SE
Salem, OR 97312-1000
Toll Free 1-800-285-8525
OREGON WORKERS COMPENSATION
CERTIFICATE OF INSURANCE
MAIL TO:
CERTIFICATE HOLDER:
CITY OF ASHLAND
ATT KARl OLSON
90 N MOUNTAIN
ASHLAND, OR 97520
CITY OF ASHLAND
A TT KARl OLSON
90 N MOUNTAIN
ASHLAND, OR 97520
The policy of insurance listed below has been issued to the insured named below for the policy
period indicated. The insurance afforded by the policy described herein is subject to all the
terms exclusions and conditions of such policy.
POLICY NO.
524679
INSURED:
PATHWAY ENTERPRISES
655 WASHINGTON ST
ASHLAND, OR 97520-3705
POLICY PERIOD ISSUE DATE
04/01/2009 to 04/01/201 0 06/01/2009
BROKER OF RECORD:
RUSS SCHWEIKERT
801 O'HARE PARKWAY #101
MEDFORD, OR 97504
LIMITS OF LIABILITY
Bodily Injury by Accident $500,000 each accident
Bodily Injury by Disease $500,000 each employee
Bodily Injury by Disease $500,000 policy limit
DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS:
IMPORTANT:
The coverage described above is in effect as of the issue date of this certificate. It is subject
to change at any time in the future.
This certificate is issued as a matter of information only and confers no rights to the certificate
holder. This certificate does not amend, extend or alter the coverage afforded by the policies
above.
AUTHORIZED REPRESENTATIVE
PJr?}>' JF ~cq4iJ--
......
President and CEO
CITY RECORDER
INSURED