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HomeMy WebLinkAboutInsurance Certificate: Community Health Center Inc CERTIFICATE OF LIABILITY INSURANCE 6/29i2o1NY2" 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 be endorsed. If SUBROGATION 15 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). CONTACT Julie Asher PRODUCER NAME: Ashland Insurance Inc PHONE (541)482-OB31 FAX o.(541)4OB-5551 585 A Street Suite 1 E'1PREs ,jasher @ashlaadinsurance.com P. O: BOX 880 INSURERISI AFFORDING COVERAGE NAICY Ashland OR 97520 INSURER A klutual of Enumclaw 14761 INSURED INSURERS: Community Health Center Inc INSURER C: 8385 Division Rd INSURER D: INSURER E: White City OR 97503-1176 INSURERP: COVERAGES CERTIFICATE NUMBER:CL12 62 903 6 43 REVISION NUMBER: THIS IS TO CER'rlrY 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 MICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POUCYNUMBER fPOLIC EFF MMIOOYIY ENIP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIAOIUTY PREMISES En occumancel 3 300,000 A CLAMS-MADE ❑X OCCUR X PP000663201 /1/2012 /1/2013 MEDEXP(Myone amen) S 10,000 PERSONAL S ADV INJURY 5 1,000,D00 GENERAL AGGREGATE 3 2,000,000 OEN'L AGGREGATE LINT APPLIES PER: PRODUCTS•COMP/DP AGO S 2,000,000 X POLICY FRO LOC 5 COMBWEO R AAUTOMOBILE LIABILITY Fa eaJdenl l 5 BODILY INJURY(Pwpem.) 3 ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Pereccideldl 5 AUTOS NON-OWNED PROPERTY DlllAA $ HIRED AUTOS AUTOS werrJdenl $ UMURELLA LIAN OCCUR EACH OCCURRENCE 5 EXCESS LIAO CLA.ws-IAAOE AGGREGATE 5 OED RETENTION 5 YJC STATU- DTI+ WORKERS COMPENSATION - AND EMPLOYERS LABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE❑ NIA E.L.EACH ACCIDENT S OFFICERIMEMBER E%CLUOE01 (Mandatory le NHl EL DISEASE-FAEMPLOYE 5 1lyos,d.s.iho nde, EL DISEASE•POLICY LIMIT S OESCRIP TION OF OFE NATIONS L.iow T77 =' I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AltReh ACORD 101,Additional Ramada,Schedule,It more space is required) Certificate Holder Is Additional Insured. CERTIFICATE HOLDER CANCELLATION campost@ashla.nd.or.us SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland Its Officers, Employees b Agents AUTiORILEO REPRESENTATIVE Vvv ` � Bryn Morrison I 20 E Main St Ashland, OR 97520 ACORD 25(2010106) © �88-2010 ACORD CORPORATION. All rights reserved. INS026(millospi The ACORD name and logo are registere arks of ACORD