HomeMy WebLinkAboutInsurance Certificate: Brotherton Pipeline
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID ME 1 DATE (MMIDDIYYYY)
9BROTPI ,06/08/10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hart Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P, 0, Box 1240 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Grants Pass OR 97528
Phone: 541-479-5521 Fax:541-474-1890 INSURERS AFFORDING COVERAGE NAlC#
INSURED INSURER A:. Travel.ers Indemnity Co. 10647
INSURER B: Travelers Property Casual ty Co 10647
Brotherton Pipeline, Inc. INSURER C: SAIF CORP
Brotherton Corporat~on
11 South Frontage Road INSURER 0:
Gold Hill OR 97 25
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 PAlO CLAIMS.
lTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDfYY DATE MMIDDIYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE .1,000,000
-
A X X COMMERCIAL GENERAL LIABILITY DTC0526D9764 06/10/10 06/10/11 PREMISES (Ea occurence) .300,000
-h CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000
PERSONAL & AnV INJURY $1,000,000
GENERAL AGGREGATE .2,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPfOP AGG .2,000,000
I POLICY [Xl ~f& n LOG
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- .1,000,000
B ~ ANY AUTO DT810526D9764 06/10/10 06/10/11 (Ea accident)
- ALL OWNED AUTOS BODILY INJURY
(Per person) .
- SCHEDULED AUTOS
- HIRED AUTOS BODlL Y INJURY
(Per accident) .
- NON-OWNED AUTOS
- PROPERTY DAMAGE .
(Per accident)
RRAGE UABIlITY AUTO ONLY. EA ACCIDENT .
ANY AUTO OTHER THAN EA ACC .
AUTO ONLY: AGG .
~ESSIUMBRELLA L1ABIUTY EACH OCCURRENCE .2,000,000
B X OCCUR D CLAIMS MADE DTSMCUP526D9764 06/10/10 06/10/11 AGGREGATE .2,000,000
.
~ DEDUCTIBLE .
X RETENTION .10000 .
WORKERS COMPENSATION AND X ITORY LIMITS , IU~~-
C EMPLOYERS' LIABILITY 810614 10/01/09 10/01/10 .1,000,000
ANY PROPRIETOR/PARTNERlEXECUTIVE EL EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? 810614 10/01/10 10/01/11 EL DISEASE - EA EMPLOYEE . 1,000,000
~~~~~~~~s16~s below E.l. DISEASE - POLICY LIMIT '1,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS
Certificate Holder is named as Additional Insured.
CERTIFICATE HOLDER
CANCELLATION
SINGSH1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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
REPRESENTATIVES.
AUTHORIZED R IV
City of Ashland
Purchasing Representative
90 N. Mountain Avenue
Ashland OR 97520
Michelle L. E1
.ACORD 25 (2001/OB)
@ACORD CORPORATION 19BB