HomeMy WebLinkAboutInsurance Certificate: Economic & Financial Analysis
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ACORD" CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
I.....-----" 11/19/2010
THIS CERTIFICATE IS ISSUED AS A MA TIER 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 tenns 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 endorsemenUs).
PRODUCER ~2~~~CT Debbie Ligh t, CISR
Smi th & Crakes Inc. r..:J8N.fo "'1)' (541) 687-2211 I FAX
I j~ Nol: (541)344-5894
58 W 11th Ave ~D'1,AJ~ss: debbie@amithandcrakes . com
PRODUCER 00008320
~QMER.lD.f';
Euaene OR 97401 INSURER(S) AFFORDING COVERAGE NAIC#
INSURED INSURER A :AXIS Insurance Com~any
Raymond J Bartlett INSURER B :
dba: Economic & Financial Analysis INSURER C :
1408 Franklin St, INSURER 0 :
Suite 201 INSURER E :
Vancouver WA 98660 INSURER F :
COVERAGES
CERTIFICATE NUMBER'10/11 Prof
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. NOT1MTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IMTH RESPECT TO \MilCH 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 ~~.,o.,L I~~~ POLICY EFF &~M~'fv~~l LIMITS
LTR POLlCY NUMBER MMIDDfYYYY
GENERAL LIABILITY EACH OCCURRENCE . 1,000,000
I-- DAMAGE....! I.!_ RENTEu
COMMERCIAl GENERAL LIABILITY PREMISES Ea occurrence\ .
A 1 CLAIMS-MADE 0 OCCUR 'ECNOOOO79741001 0/28/20101'0/28/2011 MED EXP (Any one person) .
~ Professional Liabili~_ PERSONAL & ADV INJURY .
LJ GENERAL AGGREGATE----1 $ 1,000,000
fl'l AGG~E~lE LIMIT APPUES PER: I PRODUCTS - COMP/OP AGG I S
,
POLICY ~fR,: n lOC I I'
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .
r--- (Eaaccident)
r--- ANY AUTO BOOll Y INJURY (Per person) .
c- All OWNED AUTOS BODILY INJURY (Per accident) .
- SCHEDULED AUTOS PROPERTY DAMAGE
.
- HIRED AUTOS (Pefaccident)
NON-O\^INED AUTOS .
,- .
UMBRELLA LIAS H OCCUR EACH OCCURRENCE .
-
EXCESS L1AB CLAtMS-MADE AGGREGATE .
I-- DEDUCTIBLE .
RETENTION $ .
WORKERS COMPENSATION I T~i.ltJ,~;, I jO,!,\"
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORlPARTNERfEXECUTIVE 0 NI. E.L EACH ACCIDENT .
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) e,L DISEASE - fA EMPLOYEE $
g~~~R'ipif~ O~JPERAT10NS below E.L. DISEASE - POLICY LIMIT I $
I I I I
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, AddItional Remarks Schedule,lfmol1l space I. required)
As respects to all operations of the Insured in accordance with policy term' conditions.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Mike Faught, Public Works Director
20 East Main Street AUTHORIZED REPRESENTATIVE
Ashland, OR 97520
Debbie Light, CISR/OL "cJ ~ hU C'7'/'G1'!J;Jh.L
ACORD 25 (2009/09)
INS025 (2009091
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