HomeMy WebLinkAboutInsurance Certificate: Visar Construction
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ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDfYYYY)
~ 10/22/2010
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 ay THE POLICIES
aELOW. THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT aETWEEN THE ISSUING INSURER(S), AUTHORIZEO
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 ~~=1~CT Paula Ortiz
Beecher Carlson Insurance Agency LLC ~~9NE (541)772-1111 ~.NOJ: (541)772-3785
AJ NExt):
707 Murphy Rd j~D~~SS: paula. ortiz@beechercarlson.com
~JCER 1/:1_00011583
MfR.lD. .
Medford OR 97504 INSURER/51 AFFORDING COVERAGE NAIC#
INSURED INSURER A :American Hallmark Ins Co of TX 43494
INSURER B :
Visar Construction Co, Inc. , DBA: Sesar Homes, INSURER C :
PO Box 3101 INSURER D :
INSURER E ;
Central Point OR 97502 INSURER F :
COVERAGES
CERTIFICATE NUMBER:10-11 GL,Auto
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO 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.
INSR TYPE OF INSURANCE ~~~; 1=1 POLICY EFF ~S~~%~\ LIMITS
LTR POLICY NUMBER MMIDDIYYYY
GENERAL LIABILITY l"cL44081204 EACH OCCURRENCE $ 1,000,000
-
X COMMERCIAL GENERAL LIABILITY ~~~~~I9E~~J~~nce\ $ 100,000
A I CLAIMS-MADE W OCCUR X 10/26/2010,10/26/2011 MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
f--- GENERAL AGGREGATE $ 2,000,000
~'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
X POLICY n ~~1?T n LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
f--- (Eaaccident)
f--- ANY AUTO BODILY INJURY (Per person) $
A ALL OWNED AUTOS 4CL44081204 10/26/2010 10/26/2011
f--- BODILY INJURY (Per accident) $
f--- SCHEDULED AUTOS PROPERTY DAMAGE
X (Peraccidenl) $
ex HIRED AUTOS
NON-QWNED AUTOS Underinsuredmolorisl $ 1,000,000
ex -- ~-..,-~~ I PIP-Basic $ 15,000
-
UMBRELLA LIAS I' ~ ! (i ' , - , I: \ -~:i\\ \
f--- H ~CCUR ;D/ ., EACH OCCURRENCE $
EXCESS L1AB CLAIMS-MADE AGGREGATE $
- DEDUCTIBLE i I~, \ l nr.T 2 6 2{ 10 i \1 . I $
, nr j~;
RETENTION $ $
WORKERS COMPENSATION ';j U\ -'~ --LtC STATU-, I IOJ~-
AND EMPLOYERS' LIABILITY Y'N 1000000MlIS
ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N"
(Mandatory in NH) E.L DISEASE - EA EMPLOYE $
If yes. describe under EL. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS below
I I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
Certificate holder included as additional insured as respects general liability where required by written contract.
This form is subject to policy terms, conditions, and exclusions.
CERTIFICATE HOLDER
CANCELLATION
(541) 488-6002 SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLEO BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
20 East Main Street
Ashland, OR 97502 AUTHORIZED REPRESENTATIVE
Mike Mastroni/PAUORT f~~
ACORD 25 (2009/09)
INS025 (200909)
@1988-2009ACORDCORPORATION. All ri9hts roserved.
The ACORD name and logo are registered marks of ACORD