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Home My WebLink AboutInsurance Certificate: Public Works Mgmt ~ OP 10: MP ACORD- CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDOfYYYY) \.......---' 04/26/11 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject 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 holder in lieu of such endorsement(s). PRODUCER 641-245-1111 CONTACT NAME: United Risk Solutions. Inc. 541-245-1112 PHONE If~ No: PO Box 936 Medford, OR 97501-0067 E-MAIL ADDRESS: Jackie K. Anderberg PRODUCER . PUBLOl C INSURERlSI AFFORDING COVERAGE NAle. INSURED Public Works Management, Inc. INSURERA: Vallev Forae Insurance Co. 60 North 4th Sl INSURER B : Central Point, OR 97502 INSURER C : INSURER 0 : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER' REVISION NUMBER' 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 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 ::CIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. J~M TYPE OF INSURANCE DL ~~~, POLICY NUMBER &S~%~ ~S~W~ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 =- A ..!. 5MMERCIAL GENERAL LIABILITY 4017835216 11/03/10 11/03/11 I P~EM;SEs'i'E~~~nce\ $ 300,00 _ CLAIMS-MADE [!] OCCUR MED EXP (Anyone person) $ 10,00 PERSONAL & ADV INJURY $ 2,000,00 GENERAL AGGREGATE $ 4,000,00 ~'~AGG~EnE LIMIT APnS PER: PRODUCTS - COMPIOP AGG $ 4,000,001 POLICY ~~,Q;: lOC $ AUTOMOBILE LIABILITY COMBINED SINGLE liMIT $ 1,000,00[ - (Eaacddent) A ANY AUTO B4017835216 11103110 11/03/11 - BODilY INJURY (Per person) $ - All OWNED AUTOS BODILY INJURY (Per acddent) $ X SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Peraecidenl) $ ~ ..!. NON-OWNEDAUTOS $ $ UMBRELLA LIAB H ~CCUR EACH OCCURRENCE $ - EXCESS WAB CLAIMS-MADE AGGREGATE $ - DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION I T~~$TAJ#~ I IOJ~- AND EMPLOYERS' LIABILITY VIN ANY PROPRIETOR/PARTNERlEXECUTIVE D NI. E.l. EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? ('&mdatory In NH) E.l. DISEASE - EA EMPLOYE $ ~~;~~rp~~~ ~~~PERATIONS below E.l. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES (Attach ACORD 101, Additional Remari<. Schedule, I' mol'8 space 15 required) RE: Operations of the Named Insured. CERTIFICATE HOLDER CANCELLATION CITAS03 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN 20 E Main Street ACCORDANCE WITH THE POUCY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE I ~~~ ACORD 25 (2009/09) @1988-2009ACORDCORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD ~ OP 10: MP ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIOOIYYYY) "----" 04/26/11 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. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGAnON IS WAIVED, subject to the terms and conditions of the policy, certal~~R~OIiCies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement s . PRODUCER 541-245-1111 CONTACT NAME: United Risk Solutions. Inc. 541-245-1112 PAH..9rtt ,,"_0', Ir~Nol: PO Box 936 Medford, OR 97501.0067 E-MAIL ADDRESS: Jackie K. Anderberg PRODUCER ,... PUBL01 C INSURERfSI AFFORDING COVERAGE NAle. INSURED Public Works Management, Inc. INSURER A: Beazlev Insurance ComDanv 60 North 4th St INSURER B: Central Point, OR 97502 INSURER C : INSURER 0 : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER' REVISION NUMBER' 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 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. INSR TYPE OF INSURANCE ~~~.,o.; ~~ :SMg'ill.t. I~OWCY EXP LIMITS LTR POL.ICY NUMBER MMfDOfYYYY GENERAL. LIABILITY EACH OCCURRENCE I - PREMISES '?E~~~nce\ COMMERCIAL GENERAL LIABILITY I I CLAIMS-MADE 0 OCCUR MED EXP (Anyone person) I PERSONAl & ADV INJURY I GENERAL AGGREGATE I ~~AGG~EnE LIMIT AP~f PER PRODUCTS - COMPIOP AGG I POLICY ~M L.OG I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I - (Eaaccident) - ANY AUTO BODILY INJURY (Per person) I - ALL OWNED AUTOS BODILY INJURY (Per accident) I r- SCHEDULED AUTOS PROPERTY DAMAGE I - HIRED AUTOS (Per accident) NON-QWNEO AUTOS I - I UMBREllA LIAB H ~CUR EACH OCCURRENCE I - EXCESS L1AB CLAIMS-MADE AGGREGATE I - DEDUCTIBLE I RETENTION I I WORKERS COMPENSATION I T~g~TAJN~ I IOJb'- AND EMPLOYERS' L.IABILlTY Y/N ANY PROPRIETORlPARTNERlEXECUTIVE 0 N/. E.l. EACH ACCIDENT I OFFICERlMEMBER EXCLUDED? (MlndatorylnNHI E.L. DISEASE. EA EMPLOYEE $ g~~~~~m8~ ~~bPERATIONS below E.L.. DISEASE - POLICY LIMIT I A Professional Vl0073100201 11/03/10 11/03/11 Per Claim 1,000,000 Liability E&O Aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHJCLES (Attach ACORD 101, Addltionll Remlrtta Sehedule, if more 'pace J. required) RE: Operations of the Named Insured. CERTIFICATE HOLDER CANCELLATION CITAS03 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WIll BE DEUVERED IN 20 E Main Street ACCORDANCE WITH THE POUCY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE ~\>~ ACORD 25 (2009/09) @1988-2009ACORDCORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD