HomeMy WebLinkAboutInsurance Certificate: CVO Electrical Systems
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ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
8/14/2009
PRODUCER (541) 757-1321 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Barker-Uerlings Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
340 N W 5th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
POBox 1378
Corvallis, OR 97339 INSURERS AFFORDING COVERAGE NAIC#
INSURED CYO Eleclrical Systems, LLC INSURER A: Hartford Casualty Insurance Company
1600 SW Western Blvd., Suite 160 INSURER B: Twin City Fire Insurance Company
Corvallis, OR 97333- INSURER c, U S Specialty Insurance Company
INSURER 0:
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' DO' TYPE' P~AI.{~~~~~~g~~ ~~.fJ,~~6~~,gN
LTR NSR POLICY NUMBER LIMITS
~NERAl LIABILITY EACH OCCURRENCE $ 1,OOO,00U
A X COMMERCIAl GENERAL LIABilITY 52SBATL7259 7/5/2009 7/5/2010 I ~~~~S Ea occurencel $ 300,OOU
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 10,00U
PERSONAL &ADV INJURY $ 1,OOO,OOU
GENERAL AGGREGATE $ 2,OOO,OOU
Yl'~ AGG~EnE ,LIMIT APnStPER: PRODUCTS - COMPIOP AGG $ 2,OOO,OOU
X POLICY ~~P.T LOC
~TOMOBllE LIABILITY COMBINED SINGLE LIMIT $ 1,OOO,OOU
A ANY AUTO 52SBATL7259 7/5/2009 7/5/2010 (Eaaccident)
f--
f- ALL OWNED AUTOS BODilY INJURY
$
SCHEDULED AUTOS (Per person)
ex HIRED AUTOS BODilY INJURY
ex (Per accident) $
NON-OWNED AUTOS
f--
f-- PROPERTY DAMAGE $
(Peraccidenl)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EAACC $
AUTO DNl Y: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,OOU
A ~ OCCUR D CLAIMS MADE 52SBATL7259 7/5/2009 7/5/2010 AGGREGATE $ 1,000,OOU
$
~ DEOUCTIBLE $
X RETENTION $ 10,000 $
WORKERS COMPENSATION AND X I T~~$IfJI~s I laTH-
ER
B EMPLOYERS' LIABILITY 52WECNZ9065 7/5/2009 7/5/2010 -- 500,OOU
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYEE $ 500,OOU
If yes, describe under E.l. DISEASE - POLICY LIMIT $ 500,00
SPECIAL PROVISIONS below
OTHER
C Professional Liability US 091147105 9/1/2009 9/1/2010 Claims mad basis 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
~- t2--?o r 6
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAIL 3L- DAYS WRITTEN
Atln: Kari Olson
90 North Mountain Ave. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Ashland, OR 97520- IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE -::': - s- ~..~
~ ~ -
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988