HomeMy WebLinkAboutInsurance Certificate: Oregon Safe Tree Inc
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CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
2/22/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA TIVEL Y 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 sUb~ct to the terms
and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate older in lieu of
such endorsements. ..,~.., , ..'
PRODU~ER - " NAIC#,
BEA VERTON-TIGARD INSURANCE COMPANIES -.. ._-
-
PO BOX 23129 ... - - COMPANY . -, >
'. TIGARD;OR 97281'3129 . ", A RED SHIELD INSURANCE COMPANY 41580
COMPANY
PIIONENO. (503)620-0230 B
INSURED CO~1PANY
OREGON SAFE TREE INC C
1257 SISKIYOU BLVD #169 .
ASHLAND, OR 97520 COMPANY
[)
COMPANY
E
COVERAGES
THIS IS TO CERTIFY THAT 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 ANY CONTRACf OR OTHER DOCUMENT WITH RESPECf TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECf TO ALL THE TERMS, EXCLUSIONS
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF: INSURA.'1CE POLICY Nur-mER POLICY EFFECTIVE POLICY EXPIRATION LTh-ms.
Lll< .. DATE (Mr-1IDDIYY) DATE (MMlDDIYY)
~"'ERAL LIABILITY GENERAL AGGREGATE .. 2 000 000
A .x COMMERCIAL GENERAL LIABILITY PRODUcrS - COMPIOP AGG I 2 000 000
f- =:]CLAIMS MADE [XJ OCCUR . CNT 016518 2/04/2011 2/04/2012 PERSONAL & ADY INJURY I 000 000
OWNER'S & CONTRACTOR'S PROT 1 000 000
f- EACH OCCURRENCE
f- HIRED I NON OWNED DAMAGE TO PREMISES
RE.!\'TED TO YOU LIMIT 100 000
An One Premises
MED EXP (Any une persoo) 5000
-
OTHER
-
DESCRIPTION OF OPERATIONSILOCATIONSIVEHlCLESISPECIAL ITEMS
ALL OPERATIONS USUAL TO THE NAMED INSURED AS PER POLICY TERMS AND CONDITIONS
TREE SERVICESILANDSCAPE GARDENING
The Certificate Holder is included as an additional insured pursuant to ISO form CG 3261(10/05) an exemplar copy of which is attached
hereto for informational purposes. Note that no products-completed operations coverage is being provided to the additional insured
for liability arising after the named insured has completed its work for the additional insured on the project.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF TIlE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, TIiE ISSUING COMPA.~Y Wll.L ENDEAVOR TO MAlL
-1.0... DAYS WRI1TEN NOTICE TO TIlE CERTIFICATE HOLDER NAMED TO TIlE
CITY OF ASHLAND LEFT, EXCEPT FOR NON.PA YMENT OF PREMIUM WHEN MORE THAN 10 DAYS IS
20 E MAIN ST INDICATED, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON TIlE COMPANY, ITS AGENTS OR
ASHLAND, OR 97520 REPRESENTATIVES.
AUTIIORlZEDREPRESENTATlVE '/I ~
-"" U QiT
V IT ' . CER 00 02 106/10)
.. < "~~.
POLICY NUMBER: CNT 016518
COMMERCIAL GENERAL LIABILITY
CG 32 6110 05
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OREGON ADDITIONAL INSURED - OWNERS,
LESSEES OR CONTRACTORS - SCHEDULED PERSON
... "... ' OR ORGANIZATION
'j.'
-:~
This endorsement modifies i;;s.in;~ce p~ovided under the' following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
. CITY OF ASHLAND
20 E MAIN ST
ASHLAND, OR 97520
Location(s) Of Covered Operations:
All locations where the insured performs ongoing business operations.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II . Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury",
"property damage" or "personal and advertising
injury" caused by your ongoing operations for the
additional insured(s) at the location(s) designated
above and only to the extent that such "bodily
injury", "property damage" or "personal and
advertising injury" is caused by your negligence or
the negligence of those performing operations on
your behalf.
B. With respect to the
additional insureds,
exclusion applies:
insurance afforded to these
the following additional
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
I. All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by or
on behalf of the additional insured(s) at the
location of the covered operations has been
completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
CG 32 6110 05
Copyright, ISO Properties, Inc., 2005
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