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HomeMy WebLinkAboutInsurance Certificate: A to Z Service Inc 9AZTREE OP ID: TS CERTIFICATE OF LIABILITY INSURANCE 1 DAM 08/03D/YYYY) 08/03/11 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(ies)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 541-479-5521 NAMEACT Hart Insurance 541474-1890 PHONE FAX P.0.Box 1240 A/C No Est I: A/C N.I: Grants Pass,OR 97528 E-MAIL Hart Insurance Agency ADDRESS: INSURERS)AFFORDING COVERAGE NAIC s INSURERA:Red Shield INSURED A to Z Tree Service Inc. INSURER B: P.O. Box 1978 INSURER C: Grants Pass, OR 97528 INSURER D: 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 POLICY NUMBER MMDDIIYYYY POLICY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CNT015192 09109111 09109112 PREMISES Em=.ncel $ 100,00 CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 5,00 PERSONAL SADV INJURY $ 1,000,00 . GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Include POLICY PRO LOC Emp Ben. a JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NOWOWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- 0TH- ANDEMPLOYERS'LIABILIW YIN ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ � OFFICER/MEMBER EXCLUDED] NIA (Mandatory In NHl E.L.DISEASE-EA EMPLOYEE $ If Yes,descr ibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Equipment Floater CNT015192 09109111 09109112 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION CITYASH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E. Main Street AUTHORIZED ante Age REPRESENTATIVE Ashland,OR 97520 Hart Insurance Agency ©1988-2010 ACORD CORPORA ION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD