HomeMy WebLinkAboutInsurance Certificate: Yellow Cab of Rogue Vly
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2008-06-26 12:19
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541 552 2059
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-eR CERTlFICA TE OF LIABILITY INSURANCE 2~~:;:~~'"
TIllS CUTlJl1CATlI81SSUEP A8 A MATTER OF INFORIlATlON ONLY AND CONFER8 NO RIGHTS UPON THE CERTlFlCA'M HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEQAllVELY AMEND, EX'MND OR AL'MR THE COVERAGE AFFORPED BY ltlE POLICIES
BELOW. THl8 CERTIFICATE OF INSURANCE DOES NOT CON8T1TU'M A CONlRACT BE'lWEEN THE ISSUING INSURERC8l, AUltlORJZED
REPRE8ENTATIVE OR PIl00UCER, AND THE CERTlFICA'M HOLDER.
IMPORTANT: If lho "rlllleolo holdor 10 an ADIIITlOIlAL INSUREP, tho poUcy(lo.1 must be ondonod. If 8UBRllGATlOR 18 WAIVEP, oubJoel 10
tho torm. and eondlllono of ltIo policy, eortaln pollet.. may requlr. an endorsomom. A statement on this eottllc.. does not conI.. rights 10 th.
cortmeolo holdor In~.. ofsuoh llncIorsem s .
I'ROlIUCSl
Wllaon-HeiqoocS ~aociate.
2930 Chad Dd".
PO Box 1421
. _e
INSUReD
NAME: Andrea Pitban
- . (800) 852-5140
~iIJl;. ---'-_"'H'__
: apittm.n.8whainsurane.. com
00028210
~~.~;_~~~~.~.~.:n~~_.
0!l97~,4_0_~_1421
I I AFFc:JRDNG COVERAGE
,.......... W.. tem till tiolllll IDllurlUICe
NAU
Yellow cab Of tile IID9wo Valley, LLC
'N8UR5R 51 :
I~!;:.:-
I~D:
727 welell St.
Medfo.,d
COVERAGES
Oil 97504
CER11F1CATE NUMBER.10/H GL AI..
l~~.~
llilS IS TO CERTIfY lliAT THE POLICIES OF INSURANCE LISTEO BELON HAVE BEEN ISSUED TO lliE INSURED NAMED ABOVE FOR THE POLICY PERIOO
INDICATED, NO'lWITHSTANDING ANY REQUIREMENT, TERM OR CONDIT1QoI OF ANY CCWTRACT OR OTHER DOCuMENT WTlli RESPECT TO \\filCH llilS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED 8Y lliE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlLlHE TERMS.
EXCLUSICWSAND CONDITICflS OF SUCH POlICIES. LIMITS SHO'."m MAY HAVE BEEN R_ PAID ClAIMS,
r:f TVPE OF lNIURAHCE POUCV NlMII&R ~ __" .~__...._ ,h_.
U"""
~I!NIRAL llA8l~ EACH OCC: . 1/000,000
.l' ~.~~~t.:\Al. (.e.NERAt LlAEllLITy ':~ :;,~,,"ts' . -, , l,09! 9_91
A <;l,loJ~t~ [it] oce-UR Fw1032091 1/3/2010 1/3/2011 .~ro "liP IMv U1lt parwnj . 5,000
~ PEPSONAL " JoDV IN.J.JR '( I 1,000,000
~ GENEkAl.. AOvIU:GAlt: I 2,000,000
~l~ ~.G:EnEILMIT 7lS] f1:H' f.'P51.E:Ucrs - COlo4PJOP MG . 2.000,OOC
X P()l!<;y ~g.' loe .
AUTOMOBLE IJAIfUTV C(IM6NED SNC.l( lIMIT . 500,000
if leo1aa""'r11
NiVAUT"
,,- PPP1029S06 OO[JIL Y NJJRY (Per persQn) .
A ~ ,t(L\)~ED/4J.)rl.l~ 111/3/~10 1/3/2011
BODILY N"-JR'r' (Per .v.r.dllf"tl S
~ (.;(~HEOl.ILED AUT(IS WOPfPTV ClAMJV:.r ..---
HIPfO^IJTO~ 1Pet'.r.CldH1) .
'- -.,'
.... NON-CJY'oWWAUTvt;. Medlc.al~.;onls . 5,000
. ........
UI'lIr~ndQoM$l,Qd I 500,000
e- UIl8IIEl.U\LIAB ,[i'X.;"'" EACH OCCURRrNCr .
BeESI UAII _ _ .. __. ClAlM~.MAOE ,.,.. ..- ......--
A66kEGAl t: ...... .
,,-
- OEDIJCTlfU 1-'" .
PETENTlON I: .,,---
.
WORKERI COJillll'ENU.TTDN w::. STATU. I~
AND EMPLOVERI' IJA8Lrrt' Y/N
fl.M PPOPRIETORIPARTI\ERIE)Q:(U 1 J\fE 0 F l EA(H ACCIL'li:Nr .
OfFICERM:MeI:R EXCL.L.CEO? NfA -~, .
lllllanlWofylnNH) E l Dlr,C:Ki: . EA EIoCPtOvH $
I~~,""....nl)ool~r ,,----
SC~IPIr.m OF OPERATIONS tt__ E L OISE"Ai:>E. f'OLlCY LI.tIT .
OI!~PT1ON uP Of'IiRAmNlI LOCA'n0H8 '~lES (u.at.ACORD tot."........ RiHIlIrks 1cn.6.II..1f.... __ ta'ecprHI
1lI:: 2000 Ford Crown Vie V1n'2rAJ"CI'lW4nU33P2
REVISION NUMBER'
CER11F1CATE HOLDER
CANCELLA 110N
(541) 552-205!i SHOULD AllY 0. Tlte UllVII DnCRI8!D PoucD .. CJ\NCEU.!D BUOIIl!
Tltl _"... DAm THIllIO., Nonce W1U. III DILIV!Ilm ..
Ci ty O~ Aalll.ancl ACC_ce WI1M _I'OUCY PROVISION"
20 11:. Hain St.
_land, OR 17520 AUTHORII&D ~ItENfAT1VE
~oh&eJ. Holcomb/ALP ~.- ?!' ~<:-~
ACORD 25 (2008/08)
IN8025 '"''''''''
200S-lJE-14 11:47
$1888-2008 ACORD CORPORATION. All rfght8 re8er\lod.
Tho ACORD nom. end logo .rol'lglst_ mork. 01 ACORD
Pal:e 212