HomeMy WebLinkAboutInsurance Certificate: ACCESS f`C°Rp® CERTIFICATE OF LIABILITY INSURANCE DATE(MM DDYYY�
6/27/2012
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(ies) 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 holder in lieu of such endorsement (s).
PRODUCER WINE: Sandy Orr
Beecher Carlson Insurance Agency LLC (541)772-1111 FAG NO:(SAl)772-3785
PHONE
707 Murphy Rd .sandy.orr @beechercarlson.com
INSURER(S)AFFORDING COVERAGE NAIC II
Medford OR 97504 INSURER A Philadel hia Indemnity Ins Co iaose
INSURED INSURERS:
ACCESS INSURER C:
3630 Aviation Way INSURERD:
NSURERE:
Medford OR 97504 INSUruaF:
COVERAGES CERTIFICATE NUMBER:2012-13 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 CONDITICN 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER MMIMNYY MMICONYY
LTR LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
r"1 REN 100,000
X COMMERCIAL GENERAL LI^131LITY PREMISES Ea o=rrence E
A CLAMSMADE OCCUR PNPFL887306 7/1/2012 7/1/2013 MED EXP(Am n.Person) $ 5,000
PERSONAL B ADV INJURY E 1,000,000
CENER/ A CPEOATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP ASS $ 2,000,000
X POLICY PRO LOC $JECT F-1
AUTOMOBILE LIABILITY 1,000,000
A X MY AUTO BODILY NJURY(Per person) $
�TONNEO SCHEDULED PHPiC887306 7/1/2012 7/1/2013 BODILY NJURY(Per awdenU $
NON-OWNED PROPERTY DAMAGE E
HIRED AUTOS AUTOS PerecadeM
Undennsumd motorist $
X UMBRELLA LMB X OCCUR EACH OCCURRENCE $ 5,000,000
A EXCESS UAB CLAIMS-MADE AGGREGATE $ 5,000,000
DEU I 3E I RETENTION 101000 DROB3680b7 7/1/2012 7/1/2013 $
WORKERS COMPENSATION NC STATU- F DTH-
AND EMPLOYERS'LIABILITY YIN TORY LIMITS FR
ANY PROPRIETORIPARTNER,EXECUTIVE❑ NIA E.L.EACH ACCIDENT E
OPPICERIMEMEER EXCLUDED?
IMarI In NH) E.L.DISEASE-EA EMPLOYE S
I rs,d was urber
DESCRIPTION OF OPERATIONS below ELAISEASE-ROLICY LIMIT $
A Property coverage PHPK887306 7/1/2012 7/1/2013 Blanket B.Wftg $15,174,270
$1,000 deductible Blenlet BPP $807,850
DESCRIPTIDN OF OPERATON51 LOCATIONS I VEHICLES (Aldch ACORD 101,Atldttbnal Remarks Sehatluls,Ir more apace Is requlrotl)
Certificate holder is an additional insured as respects General Liability as required by written
contract. This form is subject to policy terms, conditions and exclusions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, N0110E WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISION&
its officers, employees 6 agents
Attn: Kristen Bakke ANrHIORIMD REPr�sEManvE
20 E Main street
Ashland, OR 97520
B Pinkham/SANDOR
ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
INS025(201005).01 The ACORD name and logo are registered marks of ACORD
Additional Named Insureds
Other Named Insureds
Access Development Corporatlon Corp [Jon-Yrorit urganl ZatiOn, Accirional Named insured
ACCESS, Inc. 403(b) Plan Additional Named Insured
Conifer Gardens Limited Partnership Additional Named Insured
OFAPPINF(022007) COPYRIGHT 2007,AMS SERVICES INC;