HomeMy WebLinkAboutInsurance Certificate: Ashland Gun Club 01/08/2013 09:42 5417347752 AUTO-CHLOR SYSTEM PAGE 01/01
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CERTIFICATE OF LIABILITY INSURANCE DATE7/17/20tMM 12
THIS CERTIFICATE IS ISSVED AS q MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER.
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THIS CERTIFICATE DOES NOT AFFIRMAtIVE LY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
OLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN T
HE ISSUING INSURER(S),
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the cenilicale holder is an ADDITIONAL INSURED, the FDIC (lesl must be endorsed. II SUBROsGATIOCertifiN Iafe S WAIVED,
subject to the terms and conditions of the Policy, certain Policies ma
y c require an endorsement. A statement on thi
confer rights to the certificate holder in lieu of such endorsement(s). does not
(PRODUCER
ACT
LDCkton Risk Services HAVE
P.O. Box 010679 HONE A%
AIC Ne. E.;), 97 .107 5407 AIC, No
Kansas City, MO 64141.0679 MAIL
OGRESS
INSURER(S) AFFORDING COVERAGE HAIG
INSURED NSURER-A: Certain Undem'riters at Uo O'S London
Ashland Gun Club NSURER-B:
P. O. Box 953, NSURER.[;
Ashland, OR 97520 NSURERO:
NSUp Eq.E:
COVERAGES CERTIFICATE NUMBER: NsuRERa:
THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABO EE 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.
H
Li IH9A U6 OUCV EFF OLICY E%P
R TYPE OF INSURANCE D MM/Domy" MM(ODNYYY)
POLICY NVMBER
A GENERAL LIAQIU" % LM201244982 09IM2012 LIMITS
00I05/2018 EACH OCCURRENCE 51000000
X OMMERGgI GENERAB(IITY DAMAGE TO RENTED
LAIMS MADE % OL CCUR UA LIA PREMISES Ee Dccmra co 900000
MEDE%P A, am enm 55000
PERSONAL d ADV INJURY $1000000
ENL AGGREGATE LIMIT APPLIES PER GENERAL AGGR GATE 52000000
PRO, PRODUCTS - COMP/OP AGO 32000000
X LACY ECT LOC
AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT S
NY AUTO Ea ecclOenl a
LL OWNED SCHEDULED BODILY INJVRV Par Perim e
UTOS AUTOS BOOILV INJVRV (per
NON.OWNED PAOFEl E
C.Ot
(RED AUTOS AUTOS PROPERTY DAMAGE
va acaaanl S
MBRELLA LIAR OCCUR
BCESS LIA9 CLAIMS MADE EACHEGATE OCCURRENCE t
ED R TENTIONI AGGREGATE S
ORXERS COMPENSATION
ND EMPLOYERS' LIABILITY C STATI DTH
YPROPRI T R/PMTNEWE%ECUTNE YIN DRY LIMBS ER
FFICERAaEMBER E%CLUDED+ NIA
ASE 7
MANDATORY INN I EE.L .L. EA DISEASE - eA
1 4brnbP uneel . eA
EMPLOYEE t
ESCRIPTION OF OPERATIONS beiP E.L. DISEASE - POLICY
LIMIT E
DESCRIPTIONOP OPERATIONS/ LOCATIONS( VEHICLES) E%CL SIGNS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN
20 E. Main St., ACCORDANCE WITH THE POLICY PROVISIONS
Ashlantl,OR 97520
AUTHORIZED REPRESENTATIVE
)CORD 25 (2070/05) The ACORD name and logo are registered marks of ACORD
110312 Insured Copy