HomeMy WebLinkAboutInsurance Certificate: Quality Fence
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PRODUCER
CERTIFICATE OF LIABILITY INSURANCE ~U~rI1 I DAT~~M;::~)
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.
Western States McMannville
1411 NW Adams
McMinnv~lle OR 9712B
Phone: 503-472-2121 Fax:503-434-5872
INSURED Quali ty Fence Co
~eliable Electric
Western Vinyl Products
Reitmann Enterprises
Steve Reitmann
114 W P~ne St
Central Po~nt OR 97502
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INSURERS AFFORDING COVERAGE
INSURER A Emplovers Mutual
INSURER B:
INSURER C'
INSURER 0
INSURER E-
NAIC#
Insurance"
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.
TNSR AUU ~ I POLICY NUMBER j POL~~~ EFFECTIVE b2flfrM~b~N I LIMITS
LTRINSRO TYPE OF INSURANCE DATE MMIODIYYYY
GENERAL LIABILITY -.g;.~H_OCCURRENCE ,1000000
- 11/19/09 11/19/10 PR~~~~~ YE~~~6u~~nce\
A X COMMERCIAL GENERAL LIABILITY 3X80749 , 100000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) , 5000
PERSONAL & AOV INJURY , 1000000
-
- GENERAL AGGREGATE , 2000000
~'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG 1$2000000
n PRO- n Emo Ben. 1000000
POLICY JECT LOC
~TOMOBILE lIABILITY COMBINED SINGLE LIMIT ,1000000
A ~ ANY AUTO 3X80749 11/19/09 11/19/10 (Eaaccident)
- ALL OWNED AUTOS BOOll Y INJURY
(Per person) $
~ SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
- ,
NON-OWNED AUTOS {Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
RGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
I EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 4000000
A ~=" D,~~, 3X80749 11/19/09 11/19/10 AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION I T~~yS~~i~S I I O~~-
AND EMPLOYERS' LIABILITY y,"
ANY PROPRIETORlPARTNERJEXECUTIVD E.L. EACH ACCIDENT $
OFF1CERlMEMBER EXCLUDED?
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $
If yes. describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
A Commercial Appl~ca 3X80749 11/19/09 11/19/10
A
DESCRIPTION OF OPERATIONS / lOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
This certificate ~s provided as evidence of l~ab~l~ty insurance but only as
respects its liability arising out of the activities by and on behalf of
the named insured
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
--PROOF DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRmEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
C~ty of Ashland REPRESENTATIVES.
20 East Main M:;tDR~E~
Ashland OR 97520
ACORD 25 (2009/01)
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