HomeMy WebLinkAboutInsurance Certificate: Beaver Tree Service
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~R CERTIFICATE OF LIABILITY INSURANCE I
OP ID DS 08.103/10
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: Ir the certificate holder Is an ADDITIONAL INSuRED, the policy!;es) 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 , NAME:
. Insurance Marketplace, Inc. {f~,N~O. E~: r CAlC, No):
:MAlL-'
. 1998 SkYPark Dr Suite. ioo ADDRESS: .' ......-, .- .-
Medford OR,,,97504 "PRODlJC"E.~ BEAVE-l
CUSTOMER lD #:
Phone: 54J:-7'79-0177 I:'ax:FAX 772-8235 -. INSURER(S) AFFORDfto!9 COVERAGE NAtC.
INSURED -,------. Saif Corporation
INSURER A ;
Beaver Tree Service, Inc. ~~ERB':
Clarenye Wangle -,
270 Wi son Road INSURER C :
Central Point OR 97502 ------
INSURER 0 :
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INSURER E :
-
INSURER F :
b
L1MIT~
COMMERCIAL GENERAL LIABILITY
I CLAIMS-MADE, D OCCUR
, .
EACH OCCURRENCE ,
PREMISES Ea occurrence) ,
MED EXP (Anyone person) ,
PERSONAL /I. ADV INJURY ,
'. GENERAL AGGREGATE ,
PRODUCTS - COMP/OP AGG ,
-.
,
-
G'EN'~ ~n~~E~AfE'L1MiT A~PLlES PER~
-l POLlc~l=~f'j:gT" n LOC
AUTOMOBIL'~ldABI[lty'
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-
-
HIRED AUTOS
~
NON-QWNED AUTOS
-
ANY AUTO
ALL OW.NED ~.UTOS
SCHEDULED AutOS
COMBINED SINGLE LIMIT
(EaaccidentJ
BODILY INJURY (Per person)
,
,
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
(Per accident)
r-
RETENTION $
A WORKERS COMPENSATION
___ A~~ ~~OYERS. L1ABILlTy______'f.,.... _
I ANY P~O;:.i<IETOPJPARTNER,EXECUTI~.
OFFICER/MEMBER EXCLUDED? LJ J A
(Mandatory in NHI
g~~~~;ps;Ib~ O~dOPERATIONS below
~:.: ,,-9~:
07/0:/10
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)07/01/11
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.__~"ClTQ~rI!~iflij~, ~K _-===-===:====-
! E.L. EACH ACCIDENT $ 1000000
~.L. DISEASE - EA EMPLOYEE $ 1000000
rE.L. DISEASE - POLICY LIMIT $ 1000000
EACH OCCURRENCE
UMBRELLA LIAB
- EXCESS UAB
U OCCUR
~J CLAIMS-MADE
AGGREGATE
DEDUCTIBLE
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DESCRIPTION OF OPERATIONS J LOCATIONS {VEHICLES (Attach ACORD 101, Additional Rema/1{s Schedule, if more-space is required)
!
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I
CERTIFICATE HOLDER
CANCELLATION
ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland
Attn: Anne Richards AUTHORIZED REPRESENT A TlVE::
20 E Main St
Ashland OR 97520
I
ACORD 25 (2009/09)
@1988.2009 ACORD CORPORATION. All fights reserved.
The ACORD name and logo are registered marks of ACORD