HomeMy WebLinkAboutInsurance Certificate: Professional Underground Srvcs
~
ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDfYYYYl
07/23/2010
PRODUCER (360) 892-5840 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Post Insurance Services, Inc. DNL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR'
1499 SE Tech Center Place ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 150
Vancouver WA 98683- INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Bi tuminous Fire , Marine
Professional Underground Services, Inc. INSURER 8:
P,O, Box 2641 INSURER c:
INSURER 0:
Euaene OR 97402- INSURER E:
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 IMTH 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 REOUCEO BY PAID CLAIMS.
1~~:I~~~l TYPE OF INSURANCE POLICY NUMBER
~NERALLlABIUTY CLP 3 540 559
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE [X] OCCUR
COVERAGES
P~;+i~:~68~IE Pg~W,~~~~N
07/22/2010 07/22/2011
A
/
/
/
/
/
/
/
/
A
~N'LAGGRE~E ,LIMIT ~ES PER:
I POLICY I X I r~8T I IlOC
~TOM08ILE LIABILITY
K ANY AUTO
_ AlL DV\'NED AUTOS
_ SCHEDULED AUTOS
..!. HIRED AUTOS
..!. NON.Q\MIlED AUTOS
/
CAP 3 540 560
/ / / /
07/22/2010 07/22/2011
/
/
/
/
/
/
/
/
/
/
/
~~GE UABILlTY
I ANY AUTO
/ /
/ /
A
07/22/2010 07/22/2011
CUP 2 588 118
~~SSIUMBRELLA LIABILITY
..!...J OCCUR 0 CLAIMS MADE
I DEDUCTIBLE
X1 ~ETENTION $ 10,000
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERlEXECUTIVE
OFFICERlMEMBER EXCLUDED?
If yes, describe under
SPECiAl PROVISIONS below
OTHER Inland Marine
/ / / /
/ / / /
/ / / /
CLP 3 540 559 07/22/2010 07/22/2011
/ / / /
/ / / /
A
LIMITS
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES Ea occurrence
MED EXP /Anv one nerson\
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMPJOP AGG $
COMBINED SINGLE LIMIT
(Eaaccident)
BODILY INJURY
{Per person)
BODILY INJURY
(Peraccidenl)
PROPERTY DAMAGE
(Peraccidenl)
AUTO ONLY. EA ACCIDENT $
OTHER THAN
AUTO ONLY:
EAACC $
AGG $
1,000,000
100,000
10,000
1,000,000
2,000,000
2,000,000
1,000,000
5,000,000
5,000,000
300,000
421,000
500
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: IS/Exit l4/Hwy 66 relocation of electric facilities from overhead to underground.
The City of Ashland is included as an additional insured with respects to the operation of the named insured.
CERTIFICATE HOLDER
( )
CANCELLATION
EACH OCCURRENCE $
AGGREGATE $
.
.
.
I T~~I~Hs I IOJ~'
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L DISEASE - POLICY LIMIT $
Rent9d/Leased
Schedulad
Daductible
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE TH REOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30
Ci ty of Ashland
90 N Mountain Ave
,
HA IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
\
PRESENTATlVES.
Ashland
ACORD 25 (2001/08)
INS0251010B).06
OR 97520-
@ACORD CORPORATION 1988
Page 1 of2