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Home My WebLink AboutInsurance Certificate: New Horizons Woodworks (2) . ~,~ l~' www.saif.com OREGON WORKERS COMPENSATION CERTIFICATE OF INSURANCE .!!'i! CERTIFICATE HOLDER: CITY OF ASHLAND 20 E, MAIN STREET ASHLAND, OR 97520 The policy of insurance listed below has been issued to the insured named below for the policy period indicated, The insurance afforded by the pOlicy described herein is subject to all the terms, exclusions and conditions of such policy, POLICY NO. 439280 POLICY PERIOD 07/01/2010 to 07/01/2011 ISSUE DATE 07/08/2010 INSURED: NEW HORIZON'S WOODWORKS INC 278 HELMAN ST ASHLAND, OR 97520-1136 BROKER OF RECORD: LIMITS OF LIABILITY: Bodily Injury by Accident Bodily Injury by Disease Body Injury by Disease $1,000,000 $1,000,000 $1,000,000 each accident each employee policy limit DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: IMPORTANT: The coverage described above is in effect as of the issue date of this certificate, It is subject to change at any time in the future. This certificate is issued as a matter of information only and confers no rights to the certificate holder, This certificate does not amend, extend or alter the coverage afforded by the policies above. AUTHORIZED REPRESENTATIVE PJr?}>' Jr l<~iJ-- - President and CEO 400 High Street SE Salem, OR 97312 p, 800,285,8525 F, 503,373,8020 Policy _Batch_ CertificateOfInsurance (' ... '. ~ ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDOIYYYY) ~ 6/29/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~~~~~CT Laesa Martindale Wilson-Heirgood Associates r~gN~" "rl" (800)852-6140 I f~ Nol: (541)342-3786 2930 Chad Drive ~~D~~SS: lmartindale@whainsurance . com PO Box 1421 ~~~~:,n~DOOO6532 Euoene OR 97440-1421 INSURER/51 AFFORDING COVERAGE NAle. INSURED INsuRERA:SAIF C01"'noration INSURER B : WHA Insurance Agency Inc, INSURER C : DBA: Wilson-Heirgood Associates INSURER D : PO Box 1421 INSURER E : Eugene OR 97440 INSURER F : COVERAGES CERTIFICATE NUMBER'10/11 we REVISION NUMBER' THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. lrf: TYPE OF INSURANCE I~~.,D..LI~~R POLICY NUMBER ':SJ6g~ ':B~%~ ~NERAL UABJLlTY COMMERCIAL GENERAl LIABILITY -l CLAIMS-MADE D OCCUR LIMITS '- '- ~'L AGGRE~.L1MIT AP~S PER: I I POLICY I I ~~8i I I LOC ~TOMOBILE L1ASIUTY L- MY AUTO ~ ALL OWNED AUTOS _ SCHEDULED AUTOS ~ HIRED AUTOS ~ NON-OWNED AUTOS $ $ $ $ $ PRODUCTS. COMP/OP AGG $ $ MED EXP (Anyone person) EACH OCCURRENCE ~~~~~J9E:~~nce PERSONAL & NJV INJURY GENERAL AGGREGATE - UMBRELLA LIAS EXCESS LIAS HOCCUR CLA1MS:MADE A _ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE 0 OFFICERlMEMBER EXCLUDED? (Mandatory!n NH) g~;~~f~8~ 'tr~~PERATIONS below N/A 15291 DESCRIPTION OF OPERATIONS f LOCATJONS / VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, If more spaco Is requIred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WilL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Kari Olson , Purchasing Representative 90 N, Mountain Ave AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Laesa Martindale/LJM ~=./R7~d~ ACORD 25 (2009/09) INS025 (200909) @1988.2009ACORDCORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD