HomeMy WebLinkAboutInsurance Certificate: Soda Inc
~
ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDfYYYYj
~ 10/5/2009
PRODUCER (541)772-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Beecher Carlson Insurance Agency LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
707 Murphy Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Medford OR 97504 _ ______ _I INSURERS AFFORDING COVERAGE I NAIC #
- - - -- ----.-
INSURED !INSURER A: Philadelphia Insurance Group ,
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Soda Inc INSURER B
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604 South 2nd, St INSURER c:
I
~~D: _______ --~- -~--_. __L- ---.----
Central IPoint OR 97502 INSURER E I
COVERAGES
THE POLlCIES 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.
I~~: 1~~~'~i TYPF'I I POLICY NUMBER I rii>fJqL~FFECTIVE I POLICY EXPIRATION i LIMITS
~ENERAL.L.IABIL.ITY I I I LEACHOCCU.RRENCE_ _~___1.,~9_,_09.Q.
LDAMAGE TO RENTED I
X I COMMERCIAL GENERAL LIABILITY (~RE~JSESJEa_occUrrence)_~_ _J._OQ,~OQ..
~_~ CLAIMS MADE W OCCURPHPK475102 110/4/2009 10/4/2010 MED EXP (Any one person)~~~ _ __!?,_O_OO~
I I PERSONAL 8. ADV INJURY ! $ EXCLUDED
_J--~--- GENERAL AGGREGATE 1$ 2,OOO,..9_0...Q.
GEN'L AGGREGATE LIMIT AP~S PER: PRODUCTS - COMPIOP AGG J.1----1.,...Q.QQ., 000
X POLICY n ~:'P~ I I LOC I
COMBINED SINGLE LIMIT I '
(Eaaccidenl)
A
~TOMOBIL.E L.IABIL.ITY
_ ANY AUTO
_ ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
-
, --:-- HIRED AUTOS
NON-QWNED AUTOS
BODILY INJURY
(Per accident)
,
F,
PROPERTY DAMAGE
(Per accident)
,
~AGE liABIliTY
H ANY AUTO
~XCESS I UMBREL.LA L.IABILlTY
OCCUR D CLAIMS MADE
DEDUCTIBLE
RETENTION $
) WORKERS COMPENSATION I
AND EMPL.OYERS' L.IABllITY Y I N
ANY PROPRIETORIPARTNERIEXECUTIVE 0
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
~~~tlt~~r~3~IS~O~S below
OTHER
I AUTO ONLY - EA ACCIDENT I $
EAACC I $
AGG I,
1$
i,
I,
I:
EACH OCCURRENCE
I OTHER THAN
AUTO ONLY:
i TWC STATU- L10TH'I
_____'-.lORy_LIMITS . LER___ ____
EL EACH ACCIDENT $
EL DISEASE - EA EMPLOYEE $
I E.L. DISEASE. POLICY LIMIT I $
DESCRIPTION OF OPERATIONS' LOCATIONS 'VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT' SPECIAL. PROVISIONS
Verification of insurance.
CERTIFICATE HOLDER
CANCELLATION
SHOUL.D ANY OF THE ABOVE DESCRIBED POLICIES BECANCEL.L.ED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER lNlLL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Finance Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Lee Tuneberg
20 E Main Street IMPOSE NO OBLIGATION OR L.IABIL.ITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Ashland, OR 97520 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~ g../'1I,J'~
Pam Breazeale/PAMBRE
ACORD 25 (2009/01)
INS025 (200901)
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