Laserfiche WebLink
acoRV CERTIFICATE OF LIABILITY INSURANC~PID G3 ~ .DATE(MM/DD/YY) <br />ARBUC-1 07/29/98 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Potts Davis & Company HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. O. Box 3 3 015 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />San Antonio TX 78265-3015 _ COMPANIES AFFORDING COVERAGE <br />I COMPANY <br />q Hartford Fire Ins Co <br />PnoneNo_800-457-2379 FaXNo.210-732-3593 __ - <br />INSURED COMPANY <br />i B <br />~ <br />~fl ._ COMPANY <br />. . . ~1 C <br />Arbuckle Costic Architects Inc O ~ __ -. <br />363 State Street ~ ~ COMPANY <br />Salem OR 97301 = ~ <br />,~ <br />COVERAGES ~ <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO~AVE BEEN~I~~IS JED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITf~N OF ANY-E~TRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TFi~E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MA VE BE6~LREDUCED BY PAID CLAIMS. __ <br />~ ~ ~~ ~ POLICY EFFECTIVE POLICY EXPIRATION <br />CO ~ POLICY NUMBER \ ~ I LIMITS <br />~TR TYPE OF INSURANCE II I DATE (MM/DD1'Y, -I DATE ('APA/DDMO , <br />~'~~. GENERAL LIABILITY <br />A~hX l COMMERCIAL GENERAL LIABILITY <br />I~ ~~~ CLAIMS MADE ~] OCCUR <br />~~~ OWNER'S & CONTRACTOR'S PROT <br />~ ~ -- <br />AUTOMOBILE LIABILITY <br />~, ANY AUTO <br />~ ALL OWNED AUTOS <br />~ SCHEDULED AUTOS <br />$~ HIRED AUTOS <br />X -~ NON-OWNED AUTOS <br />GENERALAGGREGATE $ ZOOOOOO <br />52SBAEV1248 08/14/98 08/14/99 PRODUCTS-COMP/OPAGC~$ 2000000 <br />PERSONALBADVINJURY $ ZOOOOOO <br />EACHOCCURRENCE S ZOOOOOO <br />I FIRE DAMAGE (Any one fire~S 3 ~ 0 ~ ~ ~ <br />I- <br />MED EXP (Any one person) $ 1 ~ ~ ~ ~ <br />I I COMBINED SINGLE LIMIT I$ 1 O O O O O O <br />' BODILY INJURY '~ $ <br />(Per person) <br />~ - ~ <br />57SBAEV1248 08/14/98 08/14/99 gODILYINJURY $ <br />(Per accident) !~ <br />PROPERTY DAMAGE ~ $ <br />GA i AGE LIABILITY <br />~ ANY AUTO <br />EXCESS LIABILITY <br />~ UMBRELLA FORM <br />~ OTHER THAN U."."oRELLR r;~.~?nn <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />THE PROPRIETOR/ ~ <br />INCL <br />PARTNERS/EXECUTIVE ~ <br />OFFICERS ARE~. i EXCL <br />OTHER <br />AUTO ONLY - EAACCIDENT ~ <br />OTHER THAN AUTO ONLY. <br />EACH ACCIDENT $ <br />AGGREGATE~ <br />EACH OCCURRENCE ~ $ <br />AGGREGATE ~ <br />$ <br />EL EACH ACCIDEN~ <br />El DISEASE - POLICY LIMIT $ <br />EL DISEASE - EA EMPLOYEE j$ <br />DESCRIPTION OF OPER.4TIONS/LOCATIONSNEHICLES/SPECIAL ITEMS <br />Certificate holder is named additional insured as their interest may appear. <br />*Except 10 days notice for non-pay <br />CERTIFICATE HOLDER <br />Marion County Dept of Gen Svc <br />Marion County Courthouse <br />Fifth Floor <br />100 High St NE <br />Salem OR 97301 <br />ACORD 25-S (1/95) <br />CANCELLATION <br />MARIO - 9 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />3 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY THE COMPANY, ITS GENTS OR REPRESENTATIVES. <br />all IZED REP NTATNE __ <br />~ ACORD CORPORATION 1988 <br />