HomeMy WebLinkAboutInsurance Certificate: Pump Pipe & Tank Services
ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID C1 I DATE (MM/DDIYYYY)
PUMPP-1 10/16/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Monroe & Monroe Insurance Agen HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2921 Galleria Dr. , Sui te 102 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Arlington TX 76011 .. -
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Phone:. 817:-6.40-5035,...E'ax :.817.-.6.49:-0131 .INSURERS AFEORDlNGC;O.V~R!\.G~ '. -- NAIC#
. . ~ - , . -- ..
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INSURED .. .. .-.. -----~_.~-- -- I INSURER A: Mid-Continent. Casual tv Co.: ~ 15380
! , -'-1 --
, I INSURER B:
, .. S:ervices , --
, ' Pump"piEe" & Tank .- , l.
I C'- Rober.t. McHenry INSURER c:
; .Box'r46 INSURER 0: ..,
Talent OR..97540 ; . . --,
... INSURER E: ..
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NQTWITHST ANDING
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~~~ ~s't.~ TYPE OF INSURANCE POLICY NUMBER PD~~~1'~M/DD1YYt Pgk~CEYI~~h'b^J!...~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE '1,000,000
- 11/15/09 11/15/10 PREMISES TEa occurencel
A X COMMERCIAL GENERAL LIABILITY 04GL774346 '100,000
I CLAIMS MADE [iJ OCCUR MED EXP (Anyone person) , 0
X Pollution Liab , .---- - PERSONAL & ADV INJURY , 1,000;000
X Professional Liab GENERAL AGGREGATE '3,000,000
Iil'~ AGG:EAE ~L1MIT APnS IPER: PRODUCTS - COMPIOP AGG , 3,000,000
X POLICY ~r8T lOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT ,
ANY AUTO (Eaacddenl)
. .. ~ f-:--:
... -~ ,ALL OWNED AUTOS -- . .,. . . . , -- .. BODILY INJURY --
,
. SCHEDULED AUTOS ~ .. , (Per person)
f--
I- HIRED AUTOS, .:t.; l~ sr0 '-.-~ BODILY INJURY ..
. .....t~ ~. ...-. <...: .i','=l':,'f:-i--,I,. ,
:'NO"N'-OWNEO AUTOS ...........,.... 8 ";T:,-'T;:',,,: (per accident)
f-- ',,'4' .. , -- .. . -.--
e- . PROpERTY DAMAGE- sf- - .-
,,' ' ,."', C"" . {Per accident) _I'. ",,,
- -- -- --~- , nu_ ._.. .. -- '.
,. . GARAGE LIABILITY ... - . .... AUTO ONLY - EA ACCIDENT ,
R ANY AUTO OTHER THAN EAACC ,
AUTO ONLY: AGG ,
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ,
P OCCUR D CLAIMS MADE AGGREGATE ,
,
R DEDUCTIBLE ,
RETENTION , ,
WORKERS COMPENSATION AND I TO~/ LI~:~S I I U ~~-
EMPLOYERS' LIABILITY
ANY PROPRIETORfPARTNERfEXECUTIVE -.. E.L. EACH ACCIDENT " -
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
~prCl~iS~~~~f6~s below E.L DISEASE - POLICY LIMIT ,
OTHER
A Equipment Floater 04IM36258 11/15/09 11/15/10 Owned Equ 4,900
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY E,NDORSEMENT I SPECIAL PROVISIONS
r UJ lL:i: ((;; [s" n Wi ~ rn
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. I II I
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CERTIFICATE HOLDER ill Iii UCI L L LUU~ III III CANCELLATION .
U UI "' . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
qi
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL - DAYS WRITTEN
City of Ashland NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
20 E. Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, tTS AGENTS OR
Ashland OR 97520 REPRESENTATIVES.
AUTHORIZED REPRErJ~ I!L"J ,no
1/1/ 'rf
ACORD 25 2001108 '-' \ @ACORD CORPOKATION 1988