HomeMy WebLinkAboutInsurance Certificate: Bertocchi Builders Inc
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-e-R CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDOfYYYY)
OP ID KD D3/18/11
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.
:... :--"....... .:. If me C911111ca.9 1I01~.8r IS an 1"\""....,1 " me pOIlCY\,OS, mu~. ~e enuorsea. IT; ',''-''-' ,... nl"U"'~"', S~?J~Ct to
the terms and conditions ofthe policy, certain policies may require an endorsement. A statement on this certfflcate does not confer r1ghts to the
certlflcate holder In lieu of such endorsement(s).
PRODUCER NAME:
Hart Insurance lWC'NoExtl: I lAIC, No):
1123 Roya1 Ave. ADDRESS:
Medford OR 97504 CUSTOMER 10 ,,: 9BERTBTJ
Phone:541-779-4232 Fax:541-772-3963 INSURER(S) AFFORDING COVERAGE ""c.
INSURED INSURER A : Developers Surety' Indemnity
Bertocchi Builders 1nc INSURER B :
1B60 Gabriel war
Medford OR 975D INSURER C :
INSURER 0 :
"--- INSURER E :
- ,- .' .,,_. ----
INSURERF:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CE~ ~IFY_T~I_ THE _~OllCI=S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM~~ ABOVE FO~ -.!~E !"'OllCY PERIOD
INDICATED. NOTWITHSTANDING !>NY REQUIREMENT, TERM OR CONDITION OF ANY 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. liMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSR~ POLICY NUMBER (MMlDO~ MMIODNY'I'Y) LIMITS
GENERAL LIABIUTY EACH OCCURRENCE '1,000,000
A ~ COMMERCiAl GENER.-1J. LIABILITY B1SODD11D08 03/12/11 03/12/12 PREMISES fEa occurrence) 'lDD,OOO
I CLAIMS-MADE ~ OCCI$? MED EX? (Anyone person) .5,000
X PERSONAL &'}lOv IN.A.JRY $1,000,000
GENER.-1J. AGGREGATE $2,000,000
GENt AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $2,000,000
! POliCY n'1& n LOC .
AUTOMOBILE LlABIUTY COMBINED SINGLE LIMIT .
- (Eaaccident)
AAYAllTO BODILY IN..JJRY (Per person) .
-
AlL OVvNED AUTOS BOOll Y IN..u!<Y (per accident) .
-
SCHEDUlED AUTOS PROPERTY DAMAGE
- HIRED AUTOS (Pe.raccloel'1l) .
- .
NON-OVVNED AUTOS
- .
UMBRELLA LIAB H~c~ EACH OCCURRENCE .
r- EXCESS LIAB CLAIMS-MADE AGGREGATE .
I- DEDUCTIBLE .
RE1ENTION $ .
WORKERS COMPENSATION ~TOR\-tIMI'r~ I jVER'-
AND EMPLOYERS' LIABILITY V'N
ANY PROPRIETORIPAATNER/EXECUTIVE 0 E,L. EACH ACCIDENT .
OFFICERlMEMBER EXCLUDED? IA
(Mandatory In NH) E.L. DISEASE. EA EMPLOYEE .
~~~~~s:i~ &~~ERATIONS below E,L DISEASE. POliCY LIMIT .
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attlch ACORD 101, Additional Rtmlr!ls SchtdUlt, Irmort IPICt'1 rtqulrtd)
fax to 541-5S2-2304
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORE
C1TYASH THE EXPIRATION DATE THEREOF, NOTICE WILL BE O"ELlVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland AUTHORIZED REPReSeNTATIVe
attn: Dale Peters
20 E. Main street Hart rnsurance / Medford
Ash1and OR 97520
ACORD 25 (2009/09)
@ 1888-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD