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HomeMy WebLinkAboutInsurance Certificate: Thrive 114/201z 3:01 PM (GMT) From: Rshland Insurance Inc 541-488-5851 To: 15415522059 Page 2 of 2 DATE(MMIDONYYYI CERTIFICATE OF LIABILITY INSURANCE 5/14/2012 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 certificate holder Is an ADDITIONAL INSURED, the policy(les) must he 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 holder In lieu of such endorsement(s). PRODUCER NAME: Julie Asher Ashland Insurance Inc PHONN (541)482-0831 A/CNo: f541)488-5851 585 A Street Suite 1 E'DAIL .jasher @ashlandinsurance.cam P. O. BOX 980 INSURER AFFORDING COVERAGE NAIL/ Ashland OR 97520 INSURER A:ANIRRG INSURED INSURER B: The Roque Initiative For a Vital Economy INSURER C: DBA: THRIVE INSURER O: 340 A Street Suite 205 INSURERE: Ashland OR 97520 INSURER F: COVERAGES CERTIFICATE NUMBER:CL12 5140 357 7 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 CONDITIONSOF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILA TYPEOFINSURANCE POLICY NUMBER POLICY EFF MMIIDYEXP LIMITS GENERALLIABILITY EACH OCCURRENCE $ X COMMERCIAL GENERAL LIABILITY PREMISES Be oc cuff once) $ A CLAIMSMADE OCCUR X 012-27698 /1/2012 /1/2013 MED EXP(Any on a person) $ PERSONAL B AOV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGG $ POLICY PRO LOC $FrT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Peraccei $ AUTOS AUTOS HIRED AUTOS AUTOS (Per Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIM SMADE AGGREGATE $ DED I I RETENTION$ I I $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMIT ER ANY PROPRIETORIPARTNERIE)ECUTIVE E.L.EACH ACCIDENT $ OF110ERIMEMBER EXCLUDED' F-1 NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ r yam,dencrme under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks&nodule,If more apace Is regdred) Certificate holder is additional insured when required by written contract or agreement as respects liability arising from operations of insured on their behalf. Coverage is subject to the policy terms, conditions and exclustions. CERTIFICATE HOLDER CANCELLATION (541)552-2059 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland, Its officers and ACCORDANCE WITH THE POLICY PROVISIONS. employees Bryn Morrison Finance Dept AUTHORIZED REPRESENTATIVE 20 East Main St Ashland, OR 97520 Julie Asher/JAA y� ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD