HomeMy WebLinkAboutInsurance Certificate: Beecher Carlson Insurance
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ACORD" CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMfDDfYYYYJ
\__/ 12/16/2009
PRODUCER (541)~72-1111 FAX: (541) 772-3785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Beecher Car1soD.Insurance Agency LLC ONLY AND CONFERS NO RIGHTS .UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES' NOT AMEND, EXTEND OR
."707 Mu~hY Rd' ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
,""('.'. ..:. -'-- I-NAlC # __u
Medford -. -. OR 97504 INSURERS AFFORDING COVERAGE
INSURED INSURER ~...:American Hallmar)(. Ins Co of - -143494-
wiima: , LLC INSURER E: Deve10pers surety & Indemnity I
744 Helman street INSURER C I
INSURER D I
Ashland I OR 97520 INSURER E I
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWrTHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO \NHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BYTHE 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 ~og; ~p, n, '"" 'O'NC' POLICY NJMBER I POLICY EFFEcnVE b~W7M~X,b~N LIMITS
LTIl DATE MMIDDfYYYY
~NE;RAL LIABILITY ~,. orrUPpE;NCE; , 1 000 000
X COMMERCIAL GENERAL lIA8I~ITY P~~ISES YE~~~~~encel S 100 000
A I CLAIMS MADE [iJ OCCUR )44CL45754301 1/6/2010 1/6/2011 MED EXP (Ally one person) , 5 000
I-- P=.RSONAL & P-DV INJJRY , 1 000 000
I-- GENERAL AGGREGATE S 2 000 000
lilt AGGREGAE LIMIT APP!..IES PER: =>ROCUCTS COMP/O=> AGG S 2 000 000
X POLlCY n PWT" n LOC I
~OMO~lLE L1ABIUTY COMBINED SINGLE LIMIT .1
IINY AUTO . (=:aaccident) . - .
- I,
- ALL O~ED AUTOS BODIL Y INJURY
SC,.E;DULED NJTOS (Per person)
r- . .
HIREOAUTOS BODILY INJJRY. . 0-
r- (Per accident) S
I-- NON-'J\r\NED AUTOS ,
f- PPOP::PTY D/lMAG:: ,
(?eraccioent)
GARAGE LIABILITY ~ ~ @ ~ID ill ~ I AVTO ONLY 7 EA ACCIDENT $
- RA.NYAUTO
OTHER THA.N EAACC $
n AUTO ONLT: AGG $
t::J~SS I UMBRELLA LIABILITY Jl UCl., "11 LUUJ ~CH OCCURRENCE $
O.CCUR D CLAIMS MADE ~ AGGR"'GAF' $
By I.
~ ~EDUCTIBLE I,
R::fENTION , I $
WORKERS COMPENSATION IT~:T~ll~ I IO.J~-
AND ~M~LOY!!I\~" LlAelLlTY VIN
ANY PROPRIETORIPARTNERIEXECUTIVE 0 E,L, EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) EL DISEASE - E.A. EMPLOYE'" $
It yas, dascribe under
SPECIAL PROVISIONS below EL DIS"'ASE - POLICY UMI, $
B I OTHER Contractors License r99.,.C 1/6/2009 11/6/2011. I Limit, $20,000
Bond- Residential
OESCRlPTION OF OpeRATIONS I LOC....TlONS I~HICLES I EXCLUSIONS ....ooeo ev eNDORSEMENT I SPECIAL PROVISIONS
Certificate holder included as additional insured per attached endorsement CG20120798 where required by written
contract. Subject to policy ter~, conditions and exclusions.
CERTIFICATE HOLDER
CANCELLATION
SHOl.l.D ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
The City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS VlJR/TTEN
c/o Richard Appichello City Attorney NOTICE TO THE CERTIFICATE HOLDER NAMEO TO nlE LEFT, BLTT FAILURE TO 00 SO SHALL
20 East Main Street
Ashland, OR 97520 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES
ALTTHORIZED REPRESENTATIVE =y.J ~ _ ~. jU..:4........
S Wilson, MI, ;.IC/SU =c.- .
ACORD 25 (2009/01)
INS025 {200901l
e 19BB_2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY
CG20120798
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -
STATE OR POLITICAL SUBDIVISIONS - PERMITS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Political Subdivision:
(If no entry appears above, information required to complete this endorsemern will be shown in the Declarations as
applicable to this endorsement.)
Section II - Who Is An Insured is amended to
include as an insured any state or political subdivi-
sion shown in the Schedule, subject to the following
provisions:
1. This insurance applies only with respect to opera.
lions performed by you or on your behalf for
which the state or political subdivision h<l.s issued
a permit.
2: rhis insurance does not apply to:
..11... "Bodily injury," "property damage" or "personal
.and advertising injury" arising out of opera-
tions performed for the state or municipality;
or
b. "Bodily injury" or "property damage" included
within the "products-completed operations
hazard".
CG20120798
Copyright, Insurance Services Office, Inc., 1997
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