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HomeMy WebLinkAboutInsurance Certificate: Siegel Planning Services LLC A °ROe CERTIFICATE OF LIABILITY INSURANCE 3/14i 012 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), JUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the -certificate holdei in lieu of such endorsement's). PRODUCER SACT Certificate Department Ross 6 Associates Insurance Services, Inc. PHONE (503)698-3833 FAI( .(503)698-3844 Oregon Licence# 612525 'MIAL .certificates @rose-ins.com 9201 SE 91st Ave, Suite 220 INSURER(S)AFFORDING COVERAGE NAICS Portland OR 97086 INSURERA:Ohio Casualty Ins. Co. INSURED INSURERS: Siegel Planning Services LLC INSURER C: 15450 Boons Ferry Road #9-145 INSURER D: Lake Oswego, OR 97035 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:20120501 REN GL AU 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSET TYPE OF INSURANCE POLICY NUMBER POUCY EFF POLICY EXP • UMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY MI cane c� f 1,000,000 A CLAMS-MADE ❑X OCCUR X 2053475426 /1/2012 /1/2013 MED UP(Any we $ 15,000 PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATE LIMIT APPLIES PER - PRODUCTS-COMPIOPAGG $ 2,000,000 X POLICY . PR0. LdC $ AUTOMOBILE LIABILITY eaca#en SINGLE 1.000.000 A ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED 2053475426 /1/2012 /1/2013 BODILY INJURY(Per mnGenq S AUTOS AUTOS X X HIRED AUTOS NON OMED PRrPE entDA $AUTOS S UMBRELLA U.4 OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE S DED I I RETENTIONS I S WORKERS COMPENSATION WCSTATU- DTH- AND EMPLOYERS'WIBIUTY ANY PROPRIETORIPARTNEILEXECUTIVE YIN NIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ IIu yes,desRibe nder DESCRIPTION OF OPERATIONS tel. E.L.DISEASE-POLICY LIMIT S t DESCRIPTION OF OPERATIONS I LOCATIONS I VE Ch ACORD 101,AddiDmal Remark a i,ffmorespaceisrequIred) The City of Ashland, it's o a, directoe ,apd em y 'a are hereby named as an additional'insured per attached form BP7996 06/09. APR Ll)IL CERTIFICATE HOLDER CANCELLATION harrism @ashland.or.us SHOULDANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Department Cummunity Development 20 E. Main Street AUTHORIZED REPRESENTATIVE Ashland, OR 97520 Tim Cockburn/SLD ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS026rommanl Tho Ar:r1Rn namo an,l Inen am mniafamri marka of ar.npn