HomeMy WebLinkAboutInsurance Certificate: Quality Fence dba Reliable Electric OCT/19/2011/WED 04: 27 PM HART INSURANCE MED FAX No, 541 772 3963 P. 001/001
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CERTIFICATE OF LIABILITY INSURANCE °"��"°°"""
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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 polIcylles) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certaln policies may require an endorsement. A statement on this certificate does not confer rights to.the
certificate holder In llau of such endorsement .
PRODUCER 541-779423
Hart Insurance S41-772.39133 PHO Uo Ear: Ax Na:
1123 Royal Ave.
Medford, OR 87506 ADDRESS,
Hart Insurance/Medford
INSURERS AFFORDING COVERAGE NNCf
INaURERA:SAIF Corp
[INSURED Quality Fence Co. INSURER d;
dba: Rellable Electric INSURERC:
P.O. Box 3985
Central Point,OR 975023985 INSURER O;
INSURERS:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS 15 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.
I% TYPEOFINSVRANCE LIMUS
DENERAL LIABIUn' 64CH OCCURRENCE $
COMMERC A_GENERAL LIASILITV PREMISES 1E. $
CWMSMADE ❑OCCUR MED ErP(Airy ane pelsnnl S
PERSO 8 ADV INJUR'r $
GENERAL AGGREGATE $
GENL AGGREGATE LIMB P IES PER: PROOUCIa-COMPNP AGG i
POLICY PRO LW $
AUTOMOBILE LNBILDY E9 atdOSn
MY AUTO
BODILY INJURY(Pwpwson) l:
SCI1p�l4ED BODILY INJURY(Per aoddeN) ;
Ames
HIRED PLT05 AVT s Pm PROR,Hly =
f
UMBRELLA LIAR OCR EACROCCURRENCE $
"Class WAS CLAJ�.MeOE AGGREGATE S
DED
cjs WORKERSCOWP ARON AI O
AND EMPLOYERS'LIABIUV
A wO RTNISIVEXECUnvE Y� NIA 738638 10/07/11 10101112 EL EACH nCCIDENr 5 500,0
(NandatoN In NHI EL DISEASE-EA EMPLOYEE $ 500,00
If oc,daseriNe,ndx RATI E.L.DISEASE-POLICY LIMIT 50000
12 09 DESCFI"M of OPERATIONS ILOCAnONS 1 VEHICLES IAaseh ACORD 101,AddlUonY R.marNs Ssh.dul.,Ir more spat.le reRUlnd)
41.488-5320
IrATW HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL 82 DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Karl Olson, Purchasing
Representative AUrHORIrEO R�ResaNrnnvE
City of Ashland Hart Insurance/Medford
90 N Mountain Ave
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