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HomeMy WebLinkAboutInsurance Certificate: Community Works �^� CERTIFICATE OF LIABILITY INSURANCE DATEIMMDOYYW) 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 pollcy(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 Beecher Carlson Insurance Agency, LLC CONTACT NAME: (EORT)Carla Helmer 220 NW 2nd Avenue, Suite 800 PHONE A/C No: Portland, OR 97209 EWAIL ADDRESS, Carla helmer@beechema[l%nn mm INSURERS AFFORDING COVERAGE NAIL P www.beechercadson.com INSURER A: Alliance INSURED INSURER B Community Works 201 W Main INSURER C: Medford OR 97504 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13393478 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. ILS ADDL SUBR POLICY EFF POLICY EXP TR TYPE OF INSURANCE LIMITS POLICY NUMBER MMIDD/YVYI' M' MMIDDYY A GENERAL LIABILITY ,/ 2012-19517 7/1/2012 7/1/2013 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES EdEoccurmence S 100,000 CLAIMS-MADE OCCUR MED EXP(My one penwn) S 10,000 Professional Liability PERSONAL B AOV INJURY S 1.000,000 ✓ Abuse&Molestation GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,000 POLICY PRO- LOC $JECT A F11-mr 2012-19517 7/1/2012 7/1/2013 EOBIIINaEED151NGLE LIMIT E 1DDD UDD BODILY INJURY(Per person) S BSCHEDULED BODILY INJURY(Per aamdent) S AUTOS NON,OWNED PPeOPE Re 1DAMAGE E AUTOS S S UMBRELLA LIAB H OCCUR EACH OCCURRENCE_ $ EXCESS LIAB CLAIMS-MADE AGGREGATE g DIED RETENTIONS S 8 S WORKERS COMPENSATION WC STATU- AND EMPLOYERS' YIN TORY LIMITS EE RR ANY PR OPRIETORIPARTNER/EXECUTIVE❑ NIA E.L.EACH.ACCIDENT b OFFICERRAEMBER EXCLUDED'! (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE E If ye%describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) All operations of the Named Insured as provided under the policy terms,conditions&exclusions. General Liability coverage includes Blanket Additional Insured coverage as required by written Contract per endl CG 20 26 07/04(Attached). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF ASHLAND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: FINANCE ACCORDANCE WITH THE POLICY PROVISIONS. 20 EAST MAIN STREET ASHLAND OR 97520 AUTHORIZED REPRESENTATIVE PORT Carla Helmer ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 13393498 (PORT) Carla Helmer 6/21/2012 11:52:51 AN Page 1 Of 2