HomeMy WebLinkAboutInsurance Certificate: Polaris Land Surveying
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ACORD'" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIOONYYY)
~ 6/30/2009
PRODUCER (303)454-9562 FAX: (303) 454-9564 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Assurance Risk Managers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2851 S. Parker Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 760
Aurora CO 80014 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Beazley Insurance 37540
Polaris Land Surveying, LLC INSURER B:
151 Clear Creek Dr. INSURER c:
Suite 101 INSURER D: .
Ashland I OR 97520 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, EXCLUSJONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
il~~~~~~ TV.' POLlCY NUMBER POLlCY EFFECTIVE ~~W:: EXPIRATION LIMITS
\ ~NERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
~'~ AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $
POLICY n ~bW,: n LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Eaaccident)
-
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
- SCHEDULED AUTOS
- HIRED AUTOS .. - BODILY INJURY
I:DJL:~ \~:' ~"- i1\Vi~r ~I (Per accident) $
- NON-QWNED AUTOS
- ---- 1\ PROPERTY DAMAGE $
!. (Per accident)
RRAGE LIABILITY I~ui JUL - 7 2009 lWJl AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EAACC $
I AUTO ONLY: AGG $
~ESS I UMBRELLA LIABILITY I _t- J EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
==i DEDUCTIBLE , $
RETENTION $ $
WORKERS COMPENSATION I T"X~~T~J#~ I IOJ~.
AND EMPLOYERS' LIABILITY VIN
ANY PROPRIETOR/PARTNER/EXECUTIVE D EL. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL. DISEASE. EA EMPLOYEE
(Mandatory tn NH) $
If yes, describe under EL. DISEASE. POLICY LIMIT $
SPECIAL PROVISIONS below
A OTHER Professional aD 6/2a/2009 6/2a/2010 Each Occurrence 500,000
Liability Aggregate 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland, Oregon and It's DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Elected Officials, Officers & Employees NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
20 E. Main St.
Ashland, OR 97520 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Lisa 1som/MARSHA -,=~:,--- "=,., --'::""--'""-~
ACORD 25 (2009/01)
INS025 (20090l)
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