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HomeMy WebLinkAboutInsurance Certificate: Beaver Tree Service Inc AtE�® CERTIFICATE OF LIABILITY INSURANCE OP ID DS DATE(MMIDDIVYYY) 10/12/11 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 - NAME: Insurance Marketplace, Inc. ac•Ne•Ext: ( /C.No): 1998 Skypark Dr Suite 100 ADDRESS: Medford OR 97504 CUSTOMERIDA: BEAVE-1 Phone:541-779-0177 Fax:FAX 772-8235 INSURER(S)AFFORDING COVERAGE _ - NAICN INSURED INSURERA: Saif Corporation Beaver Tree Service, Inc. INSURER B: - Clarence Wangle - 270 Wilson Road INSURERC: Central Point OR 97502 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ CLAIMS-MADE F-1 OCCUR MED EXP(Any one person) $ (i� - PERSONAL&ADV INJURY $GENERAL C IE U E PRODTS AGGREGATE COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: D POLICY PRO- LOC $ AUTOMOBILE LIABILITY OCT COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNEDAUTOS $ UMBRELLA LLAB OCCUR EACH OCCURRENCE $ EXCESS Luis CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $_ A WORKERS COMPENSATION 633691 07/01/11 07/01/13 TORY LIMITS ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNEIVEXECUTI IA EACHACCI DENT $ 1000000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1000000 U es,describe under - CRIPTION OF OPERATIONS beim E.L.DISEASE-POLICY LIMIT $ l0DD000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ASHLAND THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland its Officers and Employees AUTHORIZED REPRESENTATIVE 20 E Main Ave Ashland OR 97520 ©1988-2009 ACORD CORPORATION. A11 rights reserved. ACORD 25(2009109) - The ACORD name and logo are registered marks of ACORD