HomeMy WebLinkAboutPermit Correspondence 2006-12-28
DEC-28-2006
!6:37
Id Insurance
5U 342 8280
.
ACORQ CERTIFICATE OF LIABILITY INSURANCE
FAX (541)342-8280
Inc.
P.Ol/O!
PRO~R (541)687-1117
Ward Insurance Agency,
p. 0 Box 10167
Eugene, OR 97440
DATI (MWOD(YYYY)
12/28/2006
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 COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURED Betty Trotter
2941 Edgewater Drive
Eugene, OR 97401
INSURERS AFFORDING COVERAGE NAIC ,
INSURER A: Travelers Property Casualty Co
I INSURER B:
I INSURER c:
I INSURER n
IINSURERE:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA.TEO. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ~y CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~.~~ TYPE OF INSURANce POUCYNUMBER ~YJ~
GEJ<ERALUABOJ1Y 680-8293(749 10/25/2006
X COMLIERCIAl GENERAl. UABlllTY
= ~ CtAlMS MADE {!] OCCUR
E.L.. EACH ACCIDENT ,
E.L OISEASe. fA eMPLOYEf:! I
E.L.. DISEASE. POUCY UNIT I ,
$425,000 Building limit incls
Sign Coverage-Replacement Cost
Special form, $1,000 ded
CANCELLA nON
SHOULD MY Of 1l4E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE! "THE
EJlPIRATlDN DATE TltEREOF, THE ISSUING INSURER VtUJ.ENDEAVOR TO NAIL
...!2.... DAYS WRITTEN NOnce TO THE CERTIACATE HOLDER NAMED TO 1l4E LEFT,
BUT FAlWRE TO MAlL SUCH NOTICE SHAU.IMPOSI! NO OBLIGATION OR UABIUTY
OF ANY KIND UPON TH.I! INSURER, ITS AGENTS OR REPRESENTATNES.
I AUlHORtZED REPRESENTATIVE . /
Kevin BankslDARCY ~;(- ,,,!, /'L..
CACORD CORPORA nON 1988
A
POnAuw.t~~~1 u"",,
10/25/2&07 EACHOCCURREHC' .
OAUAGE TO RENTED $
MEDEXP(Any_PlISOrl) I
I PERSONAl..& ArN INJURY $
I GENERAL AGGREGATE $
I PRODUCTS. COMPIQP AGG $
GEN'L AGGREGATE UMIT APPLIES PER;
IPOUCyn~:& n=
AUT0M08I.E UABlUTY
~YAVTO
..u OMIEO AUTOS
SCHEDULEO AUTOS
HIRED AUTOS
NOH-OWNED AlJTOS
COU8lNED SINOLE UMlT
(e...~eI'f)
BOOIL Y INJURY
(Perp<<aon)
BOOll Y INJURY
,....-
PROPERTY DAMAGE
(PcrlCOldltnt)
GARAGE UASIUTY
=1 ANY AUTO
E!XCESSAlMBREUA UABJlITY
~ OCCUR 0 CLAIMS MADE
I oeOUCTlBLE
I RETENTION
.
AUTOONLY.EAACCIDENT .
EAAC;C .
.
.
.
.
.
.
OTHER THAN
Al/TOONLY;
NJIJ
EACH OCCURRENCE
AGGREGA.TE
A
WORKERS COMPENSATION AND
EMPLOVERS' lJABIUTY
Nf'( PROPRIETORlPARTNERlEXECUTIVE.
OFFICERlMEMBER EXCLUDED?
~.re'C.~~NSbelo'flt
:p'THER
roperty Coverage
I ~~T:~I
lOll>
,.
680-8293(749 10/25/2006 10/25/2007
CESCRPnoll OF OPeRA~S I LOCA~ 1 ~ICLES' EXCUl~.AQDED BY ENOORS. 'ENT 1 SPECIAL PROVISIONS
IE: 55$ MAIN ~TREET, ~PRINliFIELD, OREGON 97477 -
CERTIFICATE HOLDER
CITY OF SPRINGFIELD
ATTN DAVE BOlESBY
225 5TH STREET
SPRINGFIELD, OR 97477
ACORD 25 (2001108) FAX: (541) 726-3676
.
1. 000. oo~
10D.oDd
5.000i
1.000.0001
2.000.!lOg
2.0000001
I
I
I
I
I
I
I
.
.
~
TOTAL P.O!