HomeMy WebLinkAboutInsurance Certificate: Housing Authority of Jackson County CERTIFICATE OF COVERAGE SSUE DATE 06/011// 2 YV)
12
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
HOUSING AUTHORITIES RISK RETENTION POOL POLICIES BELOW.
7111 NE 1791H STREET
VANCOUVER,WASHINGTON 98686 COMPANIES AFFORDING COVERAGE
(360)574-9035
(360)574-9401 FAX
COMPANY HARRP
COVERED ENTITY
Housing Authorities Risk Retention Pool
HOUSING AUTHORITY OF JACKSON COUNTY LETTER A
2251 TABLE ROCK ROAD
MEDFORD,OR 97501 COMPANY
LETTER B
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED ENTITY NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTS WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN_THE INSURANCE AFFORDED BY
THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIDS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS
FIR DATE(MMFDD�YY) DATE(MM/DDRY)
A GENERAL LIABILITY
GENERALAGGREGATE 52,000,000
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2000000
CLAIMS MADE X OCCURRENCE 046-PLEAF 07/01/12 07/01/13 FIRE DAMAGE(any one Hre) 52,000.000
OWNERS'S&CONRACTOR'S PROT.
MEDICAL EXPENSES
EXCLUDED
AUTOMOBILE LIABILITY COMBINED
SINGLE LIMIT E
_ ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS (PER PERSON) S
HIRED AUTOS PROPERTY
DAMAGE s
_ NON-OWNED AUTOS
ANNUAL
AGGREGATE $
A OTHER
Declared Value Loss Limit/
PROPERTY 046-PLEAF 07/01/12 07/01/13 Per Occurrence/Replacement
SPECIAL CAUSES OF LOSS Cost/$1,000 Deductible
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAI.ITEMS
AS RESPECTS: COMMUNITY DEVELOPMENT BLOCK GRANT, Per the interest of the CERTIFICATE HOLDER As
shown below:
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 3Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OF LIABILITY OF
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ANY KIND UPON THE COMPANY.ITS AGENTS OR REPRESENTATIVES.
See attached list R6 " AUTHORIZED REPRESENTATIVE
D v
Le�JUN - 4 2012
/WILLIAM E.GREGORY,EXECUTIVE DIRECTOR
ZACenilicates&Endom mmts\2012-2013(2012-2013Vackson CounlyVack-008.doc
COVERED ENTITY: HOUSING AUTHORITY OF JACKSON COUNTY
MEMBER NO.: 046-PLEAF
COVERAGE PERIOD: 07/01/12 - 07/01/13
AS RESPECTS: COMMUNITY DEVELOPMENT BLOCK GRANT
CERTIFICATE HOLDERS:
CITY OF ASHLAND
Its Officers,Employees&Agents
ATTN: BOB NELSON
20 E.MAIN STREET
ASHLAND,OR 97520
JOSEPHINE COUNTY
- - -- HOME REPAIR PROGRAM -
ATTN: MARK SORENSEN,CDBG PROJECT MANGER
500 N.W.SIXTH STREET
GRANTS PASS,OR 97526
GOLD HILL REHABILITATION
ATTN:CITY RECORDER/TREASURER
P.0.BOX 308
GOLD HILL,OR 97525
MEDFORD EMERGENCY REPAIR
ATTN: HUD GRANT ADMINISTRATOR
200 S.IVY STREET
MEDFORD,OR 97501
Housing Authorities Risk Reteritio'dipooI
Z:\Certificates&Endom ments\2012-2013\2012-2013Vackson CountyUack-008Am