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HomeMy WebLinkAboutInsurance Certificate: Valley Slurry Seal .4) ORL7� CERTIFICATE OF LIABILITY INSURANCE OP ID MY DATE(MM /DD/YYYY) BASIC -1 02/22/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Andreini Company -San Mateo ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License 0208825 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 220 West 20th Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. San Mateo CA 94403 Phone: 650- 573 -1111 Fax: 650- 378 -4361 INSURERS AFFORDING COVERAGE NAIC INSURED INSURER A: National Union Fire Ins Co PA 19445 INSURER B: Everest National insurance co. Valley Slurry Seal Company INSURERC: State Compensation Oregon 3785 Channel Drive INSURER D: West Sacramento CA 95691 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 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. INSK AUUR. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSRC TYPE OF INSURANCE DATE (MM /DD/YYYY) DATE (MM /DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 2000000 A X COMMERCIAL GENERAL LIABILITY 0919520 03/01/10 03/01/11 P REMISES (Ea occurence) 100000 CLAIMS MADE X OCCUR MED EXP (Any one person) 10000 PERSONAL BADV INJURY 2000000 GENERAL AGGREGATE 4000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG 4000000 7 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO 8263243 03/01/10 03/01/11 (Ea accident) 2000000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY. AGG EXCESS UMBRELLA LIABILITY EACH OCCURRENCE 5000000 X OCCUR CLAIMSMADE 71C7000257091 03/01/10 03/01/11 AGGREGATE 5000000 DEDUCTIBLE RETENTION WORKERS COMPENSATION WCSIAIU UIH- AND EMPLOYERS' LIABILITY X TORY LIMITS ER C ANYIPROPRJMORJPARTNERJEECUTIVEn II 497123 OREGON 09/01/09 09/01/10 E.I. EACH ACCIDENT 1000000 EXCLUDE (Mandatory in NH) E.L. DISEASE EA EMPLOYEE 1000000 It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE POLICY LIMIT 1000000 OTHER DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS The CANCELLATION notice herein is amended to read 10 DAYS as respects any cancellation due to non payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ASHASH1 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 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 City of Ashland REPRESENTATIVES. 20 East Main Drive AUTHORIZ D REPRESENTATIVE 4shland OR 97520 n,r, ACORD 25 (2009101) ©1288 -2009 ACO ORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD