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Home My WebLink AboutInsurance Certificate: Northwest Biologic < CITY RECORDER ..' 00030864 C E R T I F I CAT E o F INS U RAN C E Issue date: 7-30-09 Producer Indemnity Excess & Surplus Agency, Inc. 1500 NW Bethany Slv Beaverton OR 97006 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. Insured SCOTT ENGLISH DBA NORTHWEST BIOLOGIC CONSULTING .324 TERRACE ST. ASHLAND OR 97520 COMPANIES AFFORDING COVERAGE Company letter A EVANSTON INSURANCE COMPANY Company letter B Company letter C Company letter D Company letter E COVERAGES This is to certify that 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. Limits shown may have been reduced by paid claims. Co Policy Policy Lt Type of Insurance Policy number Effective Expire ALL LIMITS IN THOUSANDS GENERAL LIABILITY General aggre:rate..... .$1, 000 A X Commercial General Liab. 08ELFM00104 4-02-08 4-02-10 Products-comp eted Claims made operations aggregate. . $ 1,000 X Occurence Personal & advertising injury.... $ 1,000 Owner's & contractors - protective Each occurrence........ $ 1,000 - Fire damage (any one fire) . . . . . . . . . . . . . $ 50 - Medical expense (any one person) .. . ...... .. $ 5 AUTOMOBILE LIABILITY CSL $ - Anr auto Al owned autos Bodily Injury - Scheduled autos (per person) $ - - Hired autos Non-owned autos Bodily Injury - Garage liability (per accident) $ - - Property damage $ EXCE$S LIABILITY Each occurrence Aggregate Umbrella form - Other than umbrella form $ $ WORKERS' COMPENSATION Statutory AND $ (each accident) $ (disease-policy limit) EMPLOYERS' LIABILITY $ (disease-each empl.) OTHER A X POLLUTION LIABILITY 08ELFM00104 4-02-08 4-02-10 $1,000,000 CLAIM(AGG A X PROFESSIONAL LIAB. D8ELFM00104 4-02-08 4-02-10 $1,000,000 CLAIM(AGG Description of operations/locations/vehicles/special items PROFESSIONAL LIABILITY IS CLAIMS MADE FORM PROFESSIONAL LIABILITY RETRO DATE: 4(2(2007 PROFESSIONAL LIABILITY DEDUCTIBLE: $2,500 GL & POLLUTION LIABILITY DEDUCTIBLE: $2,500 CERTIFICATE HOLDER IS AN ADDITIONAL INSURED PER ATTACHED FORM IE-0036-0404 Certificate holder CITY OF ASHLAND ENGINEERING DEPARTMENT 20 E MAIN STREET ASHLAND OR 97520 CANCELLATION Should any of the above described policies be cancelled before the expiration date thereof, the issuing compan~ will endeavor to mail 30* days written notice to the certlficate holder named to the left, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. Authorized representative "f}"'~ -L.~ db1/. ,(J-r'd~~~~~~:~ p-o. O.Y) ( ,;::LCJ , . POLICY NUMBER: 08ELFMOOI04 ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART CONTRACfORS POLLUTION LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: AS PER WRITTEN CONTRACT (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section TI) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of ''yoW' work" for that insured by or for you. "Insureds are advlsed that certlflcates of Insnrance shonld be used only to provide evidence of insurance In lien of an actual copy of the applicable Insurance polley. Certificates shonld not be used to amend, expand, or otherwise alter the terms of the actual policy." ALL OTHER TERMS AND CONDITIONS REMAJN TIlE SAME. IE-Il03/H1404 I of!