HomeMy WebLinkAboutInsurance Certificate: Brotherton Pipeline (Rented Equip/Contents)
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
OP 10 ME I DATE (MMIDONYYY)
9BROTPI 06/08/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
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
P. O. Box 1240
Grants Pass OR 97528
Phone: 541-479-5521
INSURED
Fax:541-474-1890
INSURERS AFFORDING COVERAGE
INSURER A:. Travelers Indemni tv Co.
TravQlllrS Property Casualty Co
NAIC#
10647
10647
Brotherton Pipeline, Inc.
11 South Frontage Road
Gold Hill OR 97525
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
SAIF CORP
General Ins Co of America
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 PAlO CLAIMS,
LTR NSR~ TYPE OF INSURANCE POLICY NUMBER OATE1MMfDONYt OATE'/MMfDO,.rvY\'. LIMITS
~NERAL LIABILITY / EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY DTC0526D9764 06/10/09 06/10/10 ~~~C~~~ YE~~~~~~nce) $ 50,000
I CLAIMS MADE [!J OCCUR MED EXP (Anyone person) $ 10,000
~ PERSONAL & ADV INJURY $ 1,000,000
~ GENERAL AGGREGATE $2,000,000
I'il'L AGGREGATE LIMIT APrlS PER: PRODUCTS - COMP/OP AGG $ 2,000,000
X n PRO-
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
B ~ ANY AUTO DT810526D9764 06/10/09 06/10/10 (Eaaccident)
- AlL OWNED ALJTOS BODILY INJURY
$
- SCHEDULED ALJTOS (Per person)
- HIRED ALJTOS BODILY INJURY
$
L- NON-OWNED ALJTOS (Per accident}
X Hired Auto P.D. 06/10/09 06/10/10 PROPERTY DAMAGE
(Per accident) $
~RAGE LIABILITY AUTO ONLY -EAACCIDENT $
ANY ALJTO OTHER THAN EA ACC $
ALJTO ONLY: AGG $
~~SSJUMBRELL.A LIABILITY EACH OCCURRENCE $ 2,000,000
B X OCCUR D CLAIMS MADE DTSMCUP526D9764 06/10/.09 06/10/10 AGGREGATE $
$
~ ~EOUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X ITO~Y:;'~I~\f's I IUJ~
C EMPLOYERS' LIABILITY 810614 10/01/0B 10/01/09 $1,000,000
ANY PROPRIETORlPARTNERlEXECUTIVE EL EACH ACCIDENT
OFFICER/MEMBER E"CLUDED? E.L DISEASE - EA EMPLOYEE $1,000,000
~~~~I1r~~b6v~g?~~S below EL DISEASE - POLICY LIMIT $1,000,000
OTHER
D Rented Equipment 01CG567879 06/10/09 06/10/10 Limit/ded 250,000/500
D Contents 01CG567879 06/10/09 06/10/10 Limit/ded 310,600/500
DESCRIPTION OF OPERATIONS I LOCATIONS {VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
Ci ty of Ashland
90 N. Mountain Avenue
Ashland OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED RE~T1T1
Michelle L.' ii
ACORD 25 (2001/08)
@ACORD CORPORATION 1988