HomeMy WebLinkAboutInsurance Certificate: Robert Lloyd Sheet Metal
ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
10/01/2010
PRODUCER (503) 362-2711 THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATION
A. G. Sadowski Company (503) 362-2837 FAX ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1605 Liberty Street S.E. ALTER THE COVERAGE AFFOROED ay THE POLICIES aELOW.
Salem OR 97302- INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A, SAIF CORPORATION
Robert Lloyd Sheet Metal, Inc. CCB 1162476 INSURER B:
Stayton Heating and Cooling INSURER c:
PO Box 307 (503) 838-3863 INSURER 0:
Indenendence 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
REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO 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.
INS~ I~DD'L TYPE OF INSURANCE POLICY NUMBER Pri'}~~~:68~E Pg~feY/if:k~~N LIMITS
L TR INSRD
~NERAL L1ABIUTY / / / / EACH OCCURRENCE $
COMMERCIAL GENERAL LIABIUTY ~~~~J9~~~nce\ $
I CLAIMS MADE D OCCUR / / / / MED EXP fAn" one nerson\ $
PERSONAL & ADV INJURY $
/ / / / GENERAL AGGREGATE $
~~AGG:nEILlMJT AnE~ PER: PRODUCTS. COMP/OP AGG $
PRO- / / / /
POLICY JECT LOC
~OMOBIl.E LIABILITY / / / / COMBINED SINGLE LIMIT
(Eaaccident) $
- ANY AUTO
- ALL OWNED AUTOS / / / / BODILY INJURY
(Per person) $
- SCHEDULED AUTOS
"- HIRED AUTOS / / / / BODILY INJURY
(Per accident) $
"- NON-OWNED AUTOS
/ / / / PROPERTY DAMAGE
(Per accident) $
R~GE UABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO / / / / OTHER THAN EA ACC $
AUTO ONLY: AGG $
[jESSlUMBRELLA LIABILITY / / / / EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE / / / / $
RETENTION $ $
A WORKERS COMPENSATION AND 811507 10/01/2010 10/01/2011 X r T~~~[fJHs I 10TH-
ER
EMPLOYERS' LIABILITY 1,000,000
ANY PROPRIETORlPARTNERlEXECUTIVE E.l. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? / / / / E.l. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under 1,000,000
SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $
OTHER / / / /
/ / / /
/ / / /
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
VERIFICATION OF INSURANCE
CERTIFICATE HOLDER
CANCELLATION
( ) - ( ) - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
ATTN: KEITH WOODLEY EXPIRATION DATE THEREOF, THE ISSUING INSURER Yt'ILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT
-
ASHLAND FIRE & RESCUE FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
455 SISKIYOU BLVD. INSURER ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~ ~.
ASHLAND OR 97520-
ACORD 25 (2001108)
INS025 (0108).0.
@ACORD CORPORATION 1988
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