Laserfiche WebLink
acoRV CERTIFICATE OF LIABILITY INSURANC~P~ IIol °"osi 9~00 <br />PROOU e~- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Great Northern Underwriters HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1600 SW 4th Ave. , Suite 900 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Portland OR 97201 INSURERS AFFORDING COVERAGE <br />Phone:503-273-5672 Fax:503-273-9224 <br />INSURED INSURERA: V11I.dIIOV3 Insurance Company <br />INSURER B: <br />Barker Surveying Co . INSURER C: <br />INSURER D: <br />2036c25thnStreetkSE <br />Salem OR 97302 INSURERE: <br />COVERAGES <br />THE <br />ANY <br />MAY <br />POL <br />IN POUCIES OF INSURANCE LISTED BELOW <br />REQUIREMENT. TERM OR CONDITION OF <br />PERTA~N, THE INSURANCE AFFORDED B <br />ICIES. AGGREGATE LIMITS SHOWN MAY <br /> <br />OF INSURANCE <br />' HAVE BEEN ISSUEO TO TNt INJUtctu nHrv~~v <br />ANY CONTRACT OR OTHER DOCUMENT WITH <br />Y THE POLICIES DESCRIBED HEREIN IS SUBJE <br />HAVE BEEN ftEDUCED 5V PP.!D C141".'S~ <br />POLICY NUMBER i+ow~ ~~+~• ~~~~ • ~-• <br />RESPECT TO WHICH <br />CT TO ALL THE TERMS <br />UCY FFE IVE <br />DATE MM/DD/W ~- ~~-~ --- ~ <br />THIS CERTIFICATE MA <br />, EXCLUSIONS AND C <br />LI Y EX IRA 1 N <br />DATE MM/DD/YY <br />Y BE ISSUED OR <br />ONDITIONS OF SUCH <br /> <br />LIMRS I <br />LTR PE <br />n EACH OCCURRENCE E <br /> GENERAL LIABILITY <br />FIRE DAMAGE (My one fire) <br />3 <br /> COMMERCIAL GENERAL LIABILITY <br />MED EXP (My one Person) <br />$ <br /> CIAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ <br /> GENERALAGGREGATE $ <br /> PRODUCTS-COMP/OPAGG $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: <br />- PRO- - <br />OC <br /> L <br />POLICY <br />JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br />(Ea accident) $ <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br />(Perperson) $ <br /> SCHEDULED AUTOS <br /> HIRED AUTOS BODILY INJURY <br />(Per accident) $ <br /> NON-0WNED AUTOS <br />PROPERN DAMAGE <br />(Per accident) <br />$ <br /> <br /> UTO ONLY - EA ACCIDENT $ <br /> GARAGE LIABILITY A <br />HER THAN ~` ACC <br />$ <br /> ANY AUTO OT <br />AUTO ONLY: <br />AGG <br />$ <br /> OCCURRENCE $ <br /> EXCESS LIABILITY EACH <br />AGGREGATE <br />$ <br /> OCCUR ~ CLAIMS MADE <br />$ <br /> $ <br /> DEDUCTIBLE <br />$ <br /> RETENTION $ - - <br />ER <br />X <br /> WORKERS COMPENSATION AND <br />OYERS'LIABILITY <br />O4~OZ~OO <br />O4~OZ~O1 TORY LIMITS <br />E.L.EACHACCIDENT <br />$ ZOOOOO <br />X EMPL WC1-12O4ZZO E.L. DISEASE - EA EMPLOYE E $ 1 O O O O O <br /> E.L. DISEASE - POLICY LIMIT S S O O O O O <br /> <br /> OTHER <br />DcSi,RiH ~ ~UN JF (7PERATIONS/LGChTIONSNEHICLESIEXCLUSIONS AODED BY ENDORSEMENT/SPECIAL PROVISIONS <br />CERTIFICATE HOLDER <br />ADDITIONAL INSURED; INSURER LETTER: <br />Marion County Business Service <br />Department <br />PO Box 14500 <br />Salem OR 97309 <br />~CORD 25-S (7197) <br />~v -~ <br />~~~~~7C " S<C~Cj: ' ~> <~. C%~ <br />C <br />MARCOIIO <br />CANCELLATION <br />SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />3 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF <br />ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />'~ ACORD CORPORATION 1988 <br />