HomeMy WebLinkAboutInsurance Certificate: Bergeson-Boese
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ACORD'" CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
~ 5/4/2010
PRODUCER (541)687-1117 x207, Fax(541)342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ward Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 10167 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Eugen~, OR 97440
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Rob Harvey - INSURERS AFFORDING COVERAGE .' . .. , NAIC#
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INSURED . -- - -- . INSURER A: Endurance American Special ty
Bergeson-Boese & Associates Inc INSURER 8: Nationwide Mutual"' Ins .Company
DBA: B~&A~_ Environmental INSURER C' -
32986'Roberts Court INSURER 0:
Coburg I OR 91408 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.
INSR AOO'L.! TYPEnF I POLICY NUMBER I ~.P}Jq~~t~~ I ~~!fifrM~~~~ I LIMITS
, 04/30/2010 04/30/2011 EACH OCCURRENCE 1 000 000
~NERAL LIABILITY ECCIOIOO7042 $
DAMAGE I'T~ RENlED
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurr~nce) $ 50 000
A I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5/000
PERSONAL & ADV INJURY $ 1 000 000
GENERAL AGGREGATE $ 2 000 000
flL AGGREGATE LIMIT APPLIES PER" PRODUCTS. COMPIOP AGG $ 2,000,000
POLICY n ~~,9; n lOC
, 04/30/2010 04/30/2011
~TOMOBILE LIABILITY ACP7561541172 COMBINED SINGLE LIMIT
$ 1,000,000
~ ANY AUTO (Ea accident)
B - ALL OVvNED AUTOS BODILY INJURY
$
~ SCHEDULED AUTOS (Per person)
~ HIRED AUTOS BODILY INJURY
$
~ NON.-D'foINED AUTOS ". .. (Peraccidenl)
-
, , - }.-l ~ ~. . - PROPERTY'DAMAGE
(Per acciden~) $
RRAGE UABIUTY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A ~"'-'"-~ ,~"""'''' 04/30/2010 04/30/2011 EACH OCCURRENCE $ 1,000,000
X OCCUR D CLAIMS MADE AGGREGATE $ 1 000 000
$
DEDUCTIBLE $
RETENTION $ $
I WORKERS COMPENSATION ----.L,V'.CSTATU- UOTH-I
AND EMPLOYERS' LIABILITY VIN -- IORY...ltMlIS _ER_
ANY PROPRJETORlPARTNER/EXECUTrvE D E.L. EACH ACCIDENT $
OFFICERJMEMBER EXCLUDED?
(MandatorylnNH) E.l. DISEASE - EA EMPLOYE $
~~Etl~tS~~~~6~s below E.l. DISEASE. POLlCY LIMIT $
A OTHER POLLUTION LIAB , 04/30/2010 04/30/2011 LIMIT: $1,000,000
ECCIOIOO7042
PROFESSIONAL LIAB I 04/30/2010 04/30/2011 LIMIT: $1,000,000
ECCIOIOO7042
I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT 1 SPECIAL PROVISIONS
THE CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE ADDED AS ADDITIONAL INSUREDS IF REQUIRED BY WRITTEN
CONTRACT
..~ .- ,'~
." "
CERTIFICATE HOLDER
.,\
'"
, 'VI '; II III CANCELLATION
-
U) lUll 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
20 E MAIN STREET :r", MAY - 6 2010 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
~,~ "'iJ It \ I IMPOSE NO QBUGA TlON OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ---Z'-:?~/__-..~" C:r? . fie/t:o
~ Rob Harvey/CARSON ..-~----
~,- ,..-- .- _:~
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ACORD 2S (2009101)
INS025 (200901)
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