HomeMy WebLinkAboutInsurance Certificate: Robet Lloyd Sheet Metal
eRbe CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDOIYYYY)
OPID MB I 08/13/10
ROBER03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Western States - Al.bany HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 865 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Al.bany OR 97321
Phone: 541-926-4291 Fax:541-926-4298 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A:. .. Continental-Western Ins Co. .. '.' ..
- -~--"--1 INSURER B:
Robert Lloyd Sheet Metal Inc INSURER c:
PO .Box 307. INSURER 0: . . .. ,
'Independence OR 97351
, 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 PAID CLAIMS.
'~;; ~~~ TYPE OF INSURANCE POLICY NUMBER l,fl',!;l9~ EFF~E!))'.;. ~~~I~r~~~ LIMITS
DATE MMIDDfYYYY DATE MMIDD
GENERAL lIABILITY EACH OCCURRENCE $1,000,000
-
A X COMMERCIAL GENERAL LIABILITY CWP2771935 07/01/10 07/01/11 PREMISES lEa occurencel $100,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
Iil~AGG~EnE~lIMIT APnSIPER: PRODUCTS.COM~OPAGG $2,000,000
X POLICY ~:8i LOC Emp Ben. 1,000,000
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
A ANY AUTO CWP2771935 07/01/10 07/01/11 (Eaaccidenl)
f-
ALL OWNED AUTOS BODILY INJURY
r- $
.~ SCHEQULEO AUTOS {Per person)
f- HIRED AUTOS BODILY INJURY
NON.qWNED AYTOS , "_., (Peracddenl) $
r-
PROPERTY DAMAGE $
{Per accident) ..
GARAGE UABIUTY AUTO ONlY - EA ACCIDENT .$
R ANY AUTO OTHER THAN EAACC $
AUTO DNL V: AGG $
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ 3,000,000
A t!J OCCUR o CLAIMS MADE CU2771937 07/01/10 07/01/11 AGGREGATE $ 3,000,000
$
R DEDUCTlBLE $
. RETENTION $ $
WORKERS COMPENSATION IT~;'/~I~:i'S I xIU~;;'
ANDEMPlOYERS' L1ABIUTY VI"
A ANY PROPRIETORIPARTNERlEXECUTTI CWP2771935 07/01/10 07/01/11 ~~~H ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED'l --.
(Mandatory In NH) WA STOP GAP ONLY E.L. DISEASE. EA EMPLOYE $1,000,000
~~~ls~~~vlSTo~s below E.L. DISEASE - POLICY LIMIT $ 1,000 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Re: Ashland Fire and Rescue
f'\ITV RECORDER
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
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
John Karns
Fire Chief REPRESENTATIVES,
455 Siskiyou Blvd A~RIZED REPRESENT~TIVE
k3hland OR 97520 LM4~u/~
ACORD 25 (2009/01)
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