HomeMy WebLinkAboutInsurance Certificate: FD Thomas
Ar;ORD,. , I
CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDOIYYYY)
12/22/2009
PROOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Woodruff-Sawyer Oregon. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
100 I SW 5th A venue, Suite 500 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Portland, OR 97204
(503) 416-7180 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zurich American Insurance Comoany 16535
F.D'. Thomas, Inc. . .
POBox 4663 INSURER B: .
Me~ford, OR 97501 INSURER c:
INSURER 0: . .
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM QR 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~~: ~~~ii ~P' POLICY NUMBER Pr?AI{~~ EFFECTIVE POLICY EXPIRATION LIMITS
A ~NERAL LIABILITY CP0373910204 12/31/2009 12/31/20 I 0 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea ~~~nce\ $ 300,000
I CLAIMS MADE [K] OCCUR MED EX? (Anyone person) $ 10,000
E.. Stoo GaD S 1.000,000 PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
~.~ AGG~Er~rlllMIT APASI PER; PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY X ~~,9T LOC Contractual Liab Included
A ~TOMOBILE LIABILITY CP03739 10204 12/31/2009 12/31/2010 COMBINED SINGLE LIMIT $ 1,000,000
~ ANY AUTO (Ea accident)
- ALL OWNED AUTOS BODILY INJURY
{Per person) $- - -
SCHEDULED AUTOS
X HIRED AUTOS
c..,.- BODilY INJURY -. $ -
X NON-OWNED AUTOS (Peracddenl)
-
PROPERTY DAMAGE $ .- -
(Peraccidenl)
~~GE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
~~SSIUMBREL.L.A LIABILITY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
==J ,DEDUCT'~LE $
RETENTION $ $
WORKERS COMPENSATION AND I.);','i,~;~;,~~ I IOJb'-
EMPLOYERS' LIABILITY
E.l. EACH ACCIDENT $
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If yes, describe under E.l. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER $
$
$
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
All Operations
Operations of the Named Insured subject to policy terms and conditions
CERTIFICATE HOLDER
CANCELLA nON 10 Day Notice for Non-Payment of Premium
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Service Center NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEn, BUT FAILURE TO DO SO SHALL
90 N. Mountain Ave. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Ashland, OR 97520 REPRESENTATIVES.
I LOAN #: AUTHORIZED REPRESENTATIVE \< ~ ~~
ACORD 25 (2001108) ID #:
@ ACORD CORPORATION 1988