HomeMy WebLinkAboutInsurance Certificate: FD Thomas Inc
,ACORD~
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMlDD1YYYY)
12/21/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I
PRODUCER
Woodruff-Sawyer Oregon, Inc.
100 I SW 51h Avenue, Sui1e 1000
Portland, .OR 97204 _ . _ 00_..
(503) 416-7180...__ .____ ___
,
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INSURERS AFFORDING COVERAGEy, C :, .,-,
INSURERA, Zurich American Insurance COffioanv' ",
I"
NAIC#
16535---
INSURED .\ !." "','''_.~',:;,r_!..r:;;.
F.D. Thomas, Inc.. ,
P O'Box,4663 _::: .II...X;
Medford' OR '97501'. E,' ',U'
. -,
~ I I ~'T:- .;N- .~c 't., ..~.J:'~
INSURER B:
l ':.::'~':O,J:II:.!.\
INSURER c: : r~ .. -- , - ..-. --
,
INSURER D: , ..' .:f. ,"n," "
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 CONOITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFOROEO BY THE POLICIES OESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANO CONOITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOUCEO BY PAlO CLAIMS,
INSR DD' POLICY EFFECTIVE P~~~J,EXPIRAnON
POLICY NUMBER LIMITS
A ~NERA1 LIABILITY ~. GLA373910205 12/31/2010 12/31/2011 EACH OCCURRENCE $ 1,000,000
X CC:'I~.IERC,A!... C~N:::R.;L W.8i!..lTY P~~E~~~~~~'~.1U' , 300,000
I CLAIMS MADE 00 OCCUR MED EXP (,v,y one personl $ 10,000
~ S1o0 GaD $1.000.000 PERSONAL & AnV INJURY $ 1,000,000
f-- GENERAl AGGREGATE $ 2,000,000
~'L AGG~EMEILIMIT APnS PER: PRODUCTS'- COMP/OP AGG $ 2,000,000
POLICY X ~~g: LOC Contraciual Liab Included
~OMOBILE LIABILITY GLA373910205 12/31/2010 -
A ..- 12/31/2011 COMBINED SINGLE LIMIT $ .1,000,000
'- ...!. ANY AUTO - ..-. ... ...- (Ea accident)
-..- -- .. .. .--.- ---.--
- ALL OWNED AUTOS ; ',!:!J'~F:l..("-' BODILY INJURY
~'-~,:, "'::'~ SCH'EDULED AUTOS :~-:+.~;-;:i~-;;~; - -.-- .. ... (Per person) '.--' ,$;--- --- -- ..m_____..
. .~ .-.,:,)( :x: L__._n_____ . .---... - -. --- - , n_ _...-.
;..: HIRED AUTOS ::0;'_. ~"r. - ;:.: BODILY INJURY I
'':'11 X 'G - .-- - - . (Per~~ent).'";:- .$' . ---.-----.---
NON-DWNED AUTOS : :-.:+-~'- .. .. . -rr---- , ........,
....1 -:-=:- .... . .
-. - - -~---- - --_._~--- , .. .. -- ----- _.--,
, - PROPERTY DAMAGE $
.. . (Per accident)
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
:=lESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
==1 DEDUCTIBLE $
RETENTION $ $
iNORiI:~R.:;. COMr-Et.iSATIUNAJ.iO . I T~9.~Jf:W;, I _IOrT~'
EMPLOYERS' UABIUTY'
ANY PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT $
.
OFFICER/MEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYE $
~~~~I~'[S~'OV~S?ONS below E.L DISEASE. POLICY LIMIT $
OTHER $
$
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
All Operations
Operations of the Named Insured subject to policy terms and conditions CiTY RECORDER
CERTIFICATE HOLDER
CANCELLATION 10 Day Notice for Non-Payment of Premium
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Cily of Ashland DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Service Cen1er NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
90 N. Mounlain Ave. IMPOSE NO OBLIGATION OR LIABILITY OF AMY KlND UPON THE INSURER, ITS AGENTS OR
Ashland, OR 97520 REPRESENTATIVES.
I LOAN #: AUTHORiZED REPRESENTATIVE f{ ~ j~
ACORD 25 (2001/08) 10 #:
@ACORDCORPORATION 19BB