HomeMy WebLinkAboutInsurance Certificate: Valley Slurry Seal
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PRODUCER
Andreini , Company-San Mateo
License 0208825
220 West 20th Ave
San Mateo CA 94403
Phone: 650-573-1111 Fax:650-378-4361
CERTIFICATE OF LIABILITY INSURANCE ~BI~l I DAT~~M;::r;:1
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.
INSURERS AFFORDING COVERAGE
Valley Slurry Seal Company
elba: VSS Emultech
3785 Channel Drive
West Sacramento CA 95691
,
COVERAGES
Evere.t National Ineuranee Co.
NAIC#
19445
10120
INSURED
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
National Union Fire In. Co PA
State Compensation-Oreqon
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 mv 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
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER J~f~~~M1DD1YYYY ~~~lM~~ LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 2000000
A X COMMERCIAL GENERAL LIABILITY GL4376447 03/01/11 03/01/12 PREMISES E~~~~nce) $ 100000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) ,10000
- PERSONAl & ADV INJURY $ 2000000
GENERAl AGGREGATE $ 4000000
- $ 4000000
~'L AGG~E5flE LIMIT APrlS PER: PROOUCTS - COMP/OP AGG
POLICY X ~~8i LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2000000
- CA8263512 03/01/11 03/01/12 (Eaaccident)
A ~ ANY AUTO
- AlL OWNED AUTOS BOOIL Y INJURY
(Per person) $
SCHEDULED AUTOS
-
~ HIRED AUTOS BODILY INJURY
(Per accident) $
~ NON...QWNED AUTOS
- PROPERTY DAMAGE $
(Pereccident) .
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 5000000
B ~ OCCUR D CLAIMS MADE 71C700025709101 03/01/11 03/01/12 AGGREGATE $ 5000000
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION X ITO~/LIMWS I Iv.,t
AND EMPLOYERS' LIABILITY YIN
C ANY PROPRIETORlPARTNERlEXECUTTI 497123 - OREGON 09/01/10 09/01/11 E.l. EACH ACCIDENT $ 1000000 .
OFFICERlMEMBER EXCLUDED? $ 1000000
(Mandatory in NH) E.L DISEASE - EA EMPLOYEE
~~Et~LPA~VtS?ONS below E.l. DISEASE - POLICY LIMIT $ 1000000
OTHER
DESCRIPTION OF OPERATIONS J LOCATIONS 'VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS
The CANCELLATION notice herein is amended to read 10 DAYS as respects any
cancellation due to non payment of premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
ASHASHl DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ;!L DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Ashland
20 East Main Drive
shland OR 97520
ACORD 25 (2009/01)
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