HomeMy WebLinkAboutInsurance Certificate: Ashland Housing Opportunities Aco°R CERTIFICATE OF LIABILITY INSURANCE BAT o 0410'3/2012 3/zolz` /2012Y
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'ceitificale bolder is an ADDITIONAL INSURED, the policy(les) must be endorseA. If SUBROGATION IS WAIVED subject to _ _ e"
the tennsnand conditions,oethe-policy,certain policies may require an endorsement. A statement on this certificate does not confer fights to the 15 G, r'P
.certificate holder in lieu of such endomement(s). 1 ?• •. -+': '.'9 R I_.� ': �- - �e —� _ �'^Ns
P RO
PDUCER Phone:50&3657001 Fax 503-3657354] Il l -` CONTACT• SISKIYOU INSURANCE MARKETPLACE (GP).-, —" - -— "-
NE 1
MID VALLEY GENERAL AGENCY LLC I,� `I -- - . . :ONE [xq _1541479-6672 S::_._._ _ ..__. laic iim---1541 d74.6632
4305 RIVER ROAD N: - - - - - EMAIL - VANETTA @SISKIYOUINS.NET' Imo'
KEIZER OR 97303 ADDRESS:... _ PRODUCER 2690
CUSTOMER,,.
INSURERS) AFFORDING COVERAGE NAICe
INSURED INSURER SCOTTSDALE INSURANCE COMPANY
ASHLAND HOUSING OPPORTUNITIES,INC.
INSURER e
1215 SW"G"ST.
GRANTS PASS OR 97526 INSURER
INSURER,'
,NS+IRER E
INSURERF
COVERAGES CERTIFICATE NUMBER: 51612 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 ALLTHE TERMS,_
INSR �:•°c: voc, nr ate. AppL el2R POLICY EFF- _.POLICY F]5- _•
LTR. TYPE OF INSURARCE ..., -INSR ww POUCYNUMBER St.-r!c- - -MWDD (MLWB�YYYY� LIMBS - - -
. ..
' EACH OCCUadEi4cE�""'�--s--` 9;000;000 A. GENERAL- ...__. _ _,-CPS1159952 -"_- -03131N2 -03131/13"
I-$ X COMMERCIALGENERAI:'LIABILITY r ilj a S' Y e DAMAGETORENTED , : 100,000
PREMISES IEe we n q E
l:d»:1 e•f. ., ").e ... I_ -__-v-rl -7 - -+ 6t .{L W, ..T.e.....- i 'r)3p.0 MED.EXP IAnY One persun)YIL.S_-_._..x._ .$,669
,CLAIMS-MADE. OCCUR --,_ __».._.
PERSONAL&ADVINJURY_ „§, .. .. 1,600,000
GENERA AGGREGATE ,- § 000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG E 1,000,000
PRO- LOC E -
POLICY
AUTOMOBILE LABILITY COMBINED SINGLE LIMIT E
(Ea accdent)
ANY AUTO, BODILY INJURY(Per person) §
ALL OWNED AUTOS BODILY INJURY(Per accident)
E
SCHEDULED AUTOS PROPERTY DAMAGE
HIREDAUTOS (Per accident) §
NON-OWNEDAUTOS 1 $
UMBRELLA UhB OCCUR 7E— EACH OCCURRENCE
EXCSea LAB CLAIMSJAADE AGGREGATE
DEDUCTIBLE 012
RETENTION E E
WORMERS COMPENSATION TORYTLIMTS OT" E
AND EMPLOYERS' LABILITY YIN
ANY PROPRIETOR rrvE IPARTMEMVEXECU E.L.EACH ACCIDENT
OFRCERIYEMBER EXCLUDED? MIA
(Me.&.,In MR) E.L.DISEASE-EA EMPLOYEE
MM. eevme.under
DESCRIPnON OF OPERATIONS I. E.L.DISEASE-POLICY LIMIT §
I —
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(A DHIri ACORD 101,Additional Remarks Schedule,If more space Is required)
1971 SISKIYOU BLVD,ASHLAND,OR 97520
CERTIFICATE HOLDER CANCELLATION
CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 EAST MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS.
ASHLAND,OREGON 97520
AUTHORIZED REPHESEWANVE
Attention: ROBERT NELSON MID VALLEY GENERAL AGENCY LLC
erman'R Demss
ACORD 25(2009/09) _ - @ 1908.2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD