HomeMy WebLinkAboutInsurance Certificate: Oregon Safe Tree
02/23/2011 08:54 FAX 5418578883
ASHLAND INS-MEDFORD
1i!I001/001
~
ACOR09 CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DOfYYT'Y)
~ 2/23/2011
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, Ihe policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and condilions of the policy, certain policie5 may require an endorsemont. A statement on this certificate does not confer rights to the
certlfleate holdQr In lieu of such endorsement(s}.
PRODUCER Sf~1~CT Thomas wi 1 s on
PHONE -------- ..
Ash1a.nd Insurance Inc (Ate, Nl>,t!!.t): (5~~!.~.~~_067 9 rt,~ N_ClJ: (541) 8~!.:.:~.~.~.__._.
80~ O'Ha.re Parkway, St" 101 Z:o~~ss: twilson@a:shland;i.nsurance.com
~~~~~~~: Ie ,.00018158 --
_n___.'__U ._n 00.'_'__.'_'
Madford OR 97504 . .-. lNSUFi.ERtSJ AFFO~l?!M9S0Ve~GE _____._. ...~~--
._.n_
INSURED INSURER A :Hul1. " .Co~E.any' Northwest
.---.-
IN.~J.!I!~!Ui.L .----- - --.----
Orijlgon Safe Tree, Inc. ~f:!~U~ER c:
34 Richmond Ave -.. -.-- ---.-.--...-..- ...-- ---.
INSURER D:
.-- ....--.. .. ----- ==t=-..
)!'lSUReR E : --- ---
Medford OR 97504 INSUFi.EFi. F:
COVERAGES CERTIFICATE NUMBER:CL1~21102932 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU~O TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACr OR OTHER DOCUMENT WITH R.ESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESC~IBeo HeREIN IS SUBJECT TO ALL THE TERMS,
EX:ClUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCEO av PAID CLAIMS.
IN.S-Rl----.--.-------.-.-ADormrBRI---.-----....--... I POLJC:T'E.F~ ' j1'OLICT'E.:F'-
L TR TYPE OF INSURANCE IN R WVD POLICY NUMBER h'\r.'IltlDIT't''t'T I r-IMICOI't'TTT
GENERAL LIABILITY
=-~M5RCIAL GENER,Il.L Ll.A81L1TY
'~CLAIMS.MADE r-:: DCCUR
L1h4rTS
EACH OCCURRENCE
''"DAMAGt"TO FO.ENTED
PREMISES IE;" ~eeul'l'efl~1
$
_~ED,exp (Any one ~el'So..!!L_nl_.
GEN'L AGGREGATE LIMIT APPLIES PER.
- POLICY :-, PRO. :- LOC
! AUTOMOfllLE UABILllY
q'_ A"HlITO
ALL OWNED AUTOS
SCHeDULED Al.JTOS
r---, HIR~D AuTOS
! ' NON..()\iVNED AUTOS
I '
, I
PERSONAL &, ADV ~~.!Y~.!.__,_!_ M___'
.. ~:~~:~;~~:~:~:: AG*=-~._-~-~~~
COMBINE:O SINGl.E L1MfT r S
1 (Ealleddenl) _ __..____.
BODILY INJURY (Per D~or'l 1$
r~::~~;.~~:yM::~E~-:= ~~
IP",r acciderll)
----...--. -...- .--.-.
.,
X UhlBR~I.l.A L.IAEI OCCUR
EXCESS LIAB ' CLAIMS.lIiIADE
---..-.--....-.-.,---.-.- .
DEDUCTIBLE:
A ~ETI;NTION $
! WORKERS eOIlllPE:NSATIO/ll
I AND EMPLOYERS' LlABILlT't' 't' I '" I
I ANY PROFRIETORJPARtNENtxE.CUTlvE 0 '" I I
OfFICER/MEMBER E,>;CLUOEO? .. A
(NlIrldato.yin NI1)
1 ~~c~~cr~~ b~t;peRATION5 below :
, I
,
s0012764
2/7 /2011
~/7/2Q12
i EACH OCCuRRENCE
I~"GREGATE_
--.----..---
I
s 2,000,000
$ 2, O.~qp.~
3____.._.._. ___
.1 I6~~IfJI~sL ~~.
, 5.L, EACI-l ACCIDENT l s
~D~~~E. EA 6MPI.O""G~ ~ .
E.l. DISEASE. POLICY LIMIT S
DE:SC;RIP"rIO""O~ OP!;'llATIONS I LOCATlOIllS I VEHICLES (AHac;h ACORD 101, Adtllt[onBI R8'T1E1rkll Seh6dullt, "mor. r.pac. Is f&qulrEEl)
-~!TY RECORDER
CERTIFICATE HOLDER
(54~) 488-5320
CANCELLATION
SHOULD ANY OF THE ABOVE OESCRIEleC pOL.ICIES BE CAtIICELLEO BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WIL.L. SE: DEI.IVSRE;O IN
ACCORDANCE WITH rHI:. POLICY PROVISIONS,
City of Ashland
20 E. Main St.
Ash~a.nd, OR 97520
AUil10AIZED REPRESENTATIVE
v) r Ic:U c.c /lJ'- .
RUEls Schweikert/MARC _.~.
ACORD 25 (2009/09)
lNS025 t~OO9Cr.1\
@ 198a-2009 ACORD CORPORATION. All rights reservod.
The ACORD l14lime and IORO are reQistered marks of ACORD