HomeMy WebLinkAboutInsurance Certificate: Bob Harshman Transport
Commercial Certificate of Insurance & FAR MER S'
Agency Thomas Stanaland
. 105/1112011 I
Name . 722 Cardley Ave, Issue Date (MM/DDfYY)
& . Medford, OR 97504
Address . 541-779-5364
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
St. 73 .. Dist. 01 Agent 307 coverage afforded by the policies shown below.
Companies Ptoviding Coverage:
.. Company A
Insured Truck Insurance Exchange
. BRUCE HARSHMAN Letter
Name . BOB HARSHMAN TRANSPORT & EX! Company B Farmers Insurance Exchange
& 1254 DIXIE LN Letter .
. C Mid-Century Insurance Company
Address . MEDFORD, OR 97501 Company
Letter
Company D
Letter
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 contract or other document with respect to which this certificate may be issued or may pertain, the insurance
afforded by the polides described herein is subject to all the terms, exclusions and conditions of such policies. Limits shown may have been reduced by
paid claims.
Co. Type of Insurance Policy Number Policy Elfective Policy Expiration Policy Limits
Ltr. Date (MM/DDIYY) Date (MM/DD/YY)
General Liability General Aggregate $
Commercial General ProduclS-Comp/OPS
Liability Aggregate $
Personal &
~ Occurrence Version Advertising Injury I
Contractual - Incidental Each Occurrence , $
Only Fire Damage
(Any one fire) I
Owners & Contractors Proto Medical Expense
. (Anyone person) $
C Automobile Liability 605007572 05/06/20 II 05/06/2012 Combined Single
All Owned Commercial Limit $ 1,000,000
Autos Bodily In~ury
IC Scheduled Autos I (Per person $
Hired Autos Bodily Injury
I (Per accident) I
Non-Owned Autos
- Garage Liabilily - - - --- I -. - - Property Damage $ 1,000,000
Garage Aggregate $
Umbrella Liability Limit $
Workers' Compensation Statutory
and Each Accident I
Disease - Each Employee I
Employers' Liability Disease - Policy Limit I
Description of Operations/Vehicles/RestrictionslSpecia~ items:
VehicleCs) 1987 PETERBIL T CONVENTIONAL 377 lXPCDB9X5HD2 I 3624 & 1989 WESCO TRAILER 1 WRFH32S0KW893618
Endorsemcnt - (IF APPLICABLE, WILL BE DELIVERED WITH POLlCY).
Certificate Holder Cancellation
. CITY OF ASHLAND Should any of the above described policies be cancelled before the expiration date
Name . 90 N MOUNTAIN ST thereof, the issuing company will endeavor to mail 30 days written notice to the
& . ASHLAND OR 97520 certificate holder named to the left, but failure to mail such notice shall impose no
Address . obligation or liability of any kind upon the company, its agents or representatives.
7: (J/IAmfJ
Authorized Representative
--..-
56-2492 4-94
Copy Distribution: Service Center Copy and Agent's Copy
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