HomeMy WebLinkAboutInsurance Certificate: Brotherton Pipeline (2)
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID ME I 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. O. 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: Travelers Indemnity Co. 10647
INSURER B' Trav.alers Property Casual ty Co 10647
Brotherton Pi~eline, Inc. INSURER c: SAIF CORP
11 South Fran age Road INSURER 0: General Ins Co of America
Gold H~ll OR 97 25
INSURER E: North Pacific Insurance Co.
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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER T"dA)E MMIODIYY DATE MMJDDIYY LIMITS
GENERAL. LlABIL.1TY EACH OCCURRENCE $1,000,000
- DTC0526D9764 06/10/10 06/10/11 PREMISESIEa occurencel $ 50,000
A X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10 000
PERSONAL & ADV INJURY $1,000,000
c- $ 2,000,000
GENERAL AGGREGATE
c- $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG
rx--J POLICY n f~8i n LOC
AUTOMOBIL.E LIABILITY COMBINED SINGLE LIMIT $1,000,000
c-
B ~ ANY AlITO DT810526D9764 06/10/10 06/10/11 (Eaaccidenl)
C- ALL OWNED AlITOS BODILY INJURY
{Per person) $
c- SCHEDULED AlITOS
c- HIRED AUTOS BODILY INJURY
(Per accident) $
c- NON.QWNED ALJTOS
~ Hired Auto P.D. 06/10/10 06/10/11 PROPERTY DAMAGE
(Peraccidenl) $
RGE UABIUTY AlITO ONLY. EA ACCIOENT $
ANYALJTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
~ESSIUMBREL.LA LIABILITY EACH OCCURRENCE $ 2,000,000
B X OCCUR D CLAIMS MADE DTSMCUP526D9764 06/10/10 06/10/11 AGGREGATE $
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X I ToR'lLIMITS I IUER"
C EMPLOYERS' L.IABILlTY 810614 10/01/09 10/01/10 $ 1,000,000
ANY PROPRIETORIPARTNERlEXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL. DISEASE. EA EMPLOYEE $ 1 , 000 , 000
~~rc:~~~~~?~~S below E.L. DISEASE. POLICY LIMIT $1 000 000
OTHER
D Rented Equipment C06173989 06/10/10 06/10/11 L~mit/ded 500,000/500
D Contents 01CG567879 06/10/10 06/10/11 L~mit/ded 310 600/500
DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
C~ ty of Ashland
90 N. Mountain Avenue
Ashland OR 97520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED ~~
Michell': t :"'E:l
CORPORATION 1988
ACORD 25 (2001/08)