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OP 10: MP
ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE (..../DDIYYYY)
~ 11/22/10
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: 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, certal~~1 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 541-245-1111 CONTACT .
NAME:
United Risk Solutions, Inc. 541-245-1112 r,,~.2Ntf "'....: If~ No';
PO Box 936 e-MAIL
Medford, OR 97501-0067 ADDRESS:
Jackie K. Anderberg PRODUCE~ In.. ANSWOl C
IN5URERt5\ AFFORDING COVERAGE HAle.
INSURED Answer Page, Inc. INSURER A, Allied Property & Casualty
3709 Citation Wy INSURER B :
Medford, OR 97504 INSURER C :
INSURER 0 :
INSURER E :
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER'
THIS IS TO CERTIFY THAT 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 POLl= LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~ TYPE OF INSURANCE ~ POUCY NUMBER i I':SM%~ I/:~~%~l UMITS
~NERAL UABIUTY EACH OCCURRENCE $ 1,000,000
X X COMMERCIAL GENERAL LIABILITY ACP7514245431 11/30/10 11/30/11 I ~~~~'Es fa occurrence' $ 300,000
l CLAIMS-MADE 00 OCCUR MED EXP (Anyone person) $ 5,000
- PERSONAL & ADV INJURY $ 1,000,000
- GENERAL AGGREGATE $ 2,000,000
~'l AGG~EnE LIMIT APAS PER: PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY I ~~,9,: LaC $
~TOM08ILE UABIUTY COMBINEO SINGLE LIMIT $
(Eaaccideot)
- ANY AUTO BODILY INJURY (Per person)
$
- ALL OWNED AlITOS BODILY INJURY (Per accident)
$
- SCHEDULED AUTOS PROPERTY DAMAGE
$
~ HIRED AUTOS (Per accident)
- NON-DWNED AUTOS $
$
~ UMBRELLA LIAB }-!i OCCUR EACH OCCURRENCE $ 1,000,000
EXCESS L1AB CLAIMS-MADE AGGREGATE $ 1,000,000
A ACP7514245431 11/30/10 11/30/11 -
I- DEDUCTIBLE $
X RETENTION $ none $
WORKERS COMPENSATION I T~~~TfJI~~ I 1OJ~-
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETORlPARTNERlEXECUTIVE D E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $
g~~~~r~ir~~ O~bPERATIONS below E.l. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
RE: Operations of Named Insured. 30 day notice of cancellation applies
except 10 day notice for non payment of premium. CITY RECORDER
CERTIFICATE HOLDER
CANCELLATION
CITASOl
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn. Kari Olson
Purchasing Representative AUTHORaEDREPRESENTATWE
90 N Mountain ~,,~
Ashland, OR 97520
,
ACORD 25 (2009/09)
@1988-2009 ACORD CORPORATION, All rights reserved.
The ACORD name and logo are registered marks of ACORD