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Home My WebLink AboutInsurance Certificate: Rogue Valley Council of Governments '4`~ CERTIFICATE OF LIABILITY INSURANCE 1/8/2013YY' 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 CONTACT Marcy Baker NAME: FAX Ward Insurance Agency PHONE (541) 687-1117 . (541)342-e2e0 P O Box 10167 ADDRLE ,narcy@wardinsurance. net INSURERS AFFORDING COVERAGE NAIL A Eugene OR 97440 INSURER A:S ecial Districts Assn, of Ore INSURED INSURER B Rogue Valley Council of Governments INSURER C: PO BOX 3275 INSURER D: INSURER E: Central Point OR 97502-0011 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/AL/EX - ALL OPS 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. INSR ADDL SUSHI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/ YY MM/ D/YYYY LIMITS A GENERAL LIABILITY BP44372-429 1/1/2013 1/1/2014 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY DAMA Cff7IYTENTED PREMISES Ea occurrence S CLAIMS-MADE rx-1 OCCUR MED EXP (Any one person) E PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ None GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS -COMPIOP AGG E POLICY PRO- LOC $ FCT -1 A AUTOMOBILE LIABILITY BP44372-429 /1/2013 /1/2014 EOMaB AN4EDt SINGLE LIMIT 500,000 Ix ANY AUTO BODILY INJURY(Par person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accdent) S AUTOS AUTOS HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Underinsured motorist $ A UMBRELLA LIAB X OCCUR BP44372-429 /1/2013 /1/2014 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE S 5,000,000 DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH-TORY I IMITq FIR AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOWPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ dyes, describe ender DESCRIPTION OF OPERATIONS below - E L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: USING PROPERTY FOR MEAL SITE. ALL OPERATIONS OF THE NAMED INSURED UNDER WRITTEN CONTRACT AGREEMENT. CERTIFICATE HOLDER CANCELLATION D )JHE U EXPIRATIIONH DATE ABOVETHEREOF, NOTIICEI WILL CBE CDELI ERED IN CITY OF ASHLAND CCORDANCE WITH THE POLICY PROVISIONS. KATHY GRIFFIN CITY HALL JAN 10 2013 HORIZED REPRESENTATNE ASHLAND, OR 97520 Pa 1 Jensen/DANAK ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 1/8/2013YYY, 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 CONTACT Marc Baker NAME: Y Ward Insurance Agency PHONE (541) 687-1117 AX No: (541)342-8280 Arc N P O Box 10167 E-MAIL .marcy@wardinsurance. net INSURERS AFFORDING COVERAGE NAIC4 Eugene OR 97440 INSURER A:S ecial Districts Assn. of Ore INSURED INSURER B : Rogue Valley Council of Governments INSURERC: PO BOX 3275 INSURER D: INSURER E Central Point OR 97502-0011 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/AL/EX-AI 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. INSR ADDLSUBR POLICY EFF POLICY E%P LTR TYPE OF INSURANCE POLICY NUMBER MM/DDNYYY MM/DD YY LIMITS A GENERAL LIABILITY 8P44372-429 /1/2013 1/1/2014 EACH OCCURRENCE $ 500,000 T RENTED X COMMERCIAL GENERAL LIABILITY A PREMISES Ea occurrence $ CLAIMS-MADE F_x1OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ Norte GEN'L AGGREGATE LIMIT APPLIES PER - PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC $ A AUTOMOBILE DABILl SP44372-429 /1/2013 /1/2014 EOMaBBIIN4EDi SINGLE LIMIT 500,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS X HIRED AUTOS X AUT SWNED W.r.ddnDAMAGE It Underinsured molonst $ A UMBRELLA LIAB X OCCUR SP44372-429 /1/2013 /1/2014 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE IS 5,000,000 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN IM ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required) CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE NAMED AS ADDITIONAL INSUREDS WITH RESPECTS TO WORK PERFORMED BY THE ROGUE VALLEY COG, SUBJECT TO TERMS 6 CONDITIONS. CERTIFICATE HOLDER CANCELLATION 0(0; IE OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN D CORDANCE WITH THE POLICY PROVISIONS. CITY OF ASHLAND 2013 KATHY GRIFFIN JAN 1 0 CITY HALL A ORIZED REPRESENTATIVE ASHLAND, OR 97520 aul. Jensen/DANAK ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD 8/2013YYY) CERTIFICATE OF LIABILITY INSURANCE 1/DATE 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 CONTACT Marc Baker NAME: Y Ward Insurance Agency PHONE (541) 68"7-1117 A//CC NO' (541)342-8280 P O Box 10167 , E-MAIL .marcy@wardinsurance. net INSURERS AFFORDING COVERAGE NAICN Eugene OR 97440 INSURER A:S ecial Districts Assn. of Ore INSURED INSURER 8 Rogue Valley Council of Governments INSURERC: PO Box 3275 INSURER O INSURER E: Central Point OR 97502-0011 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/AL/EX - ALL OPS 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. INSR ADDL BR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDNYYY MMIDDNYYY LIMITS A GENERALLIABILITY 8P44372-429 /1/2013 1/1/2014 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T D PREMISES fEa RENT occurrence) E CLAIMS-MADE FxIOCCUR MED EXP (Anyone arson E PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ None GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/CP AGG $ POLICY PRO.. LOC .I - - E A POMOBILE LIABILITY- 8P44372-429 - - /1/2013 '/1'/2014- CEO MaBLNEerin -LE LIMIT 500,00 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Underinsured molonst $ A UMBRELLA LIAR X OCCUR SP44372-429 /1/2013 1/1/2014 EACH OCCURRENCE E 5,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE E 5,000,000 DEO RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER7 XECUTIVIE ❑ NIA E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED] (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: USING PROPERTY FOR MEAL SITE. ALL OPERATIONS OF THE NAMED INSURED UNDER WRITTEN CONTRACT AGREEMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS. KATHY GRIFFIN CITY HALL, AUTHORIZED REPRESENTATIVE ASHLAND, OR 97520 Paul Jensen/DANAK ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 1/8/2013""") 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. IMP,ORTANT:.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 CONTACT Marc Baker NAME: Y Ward Insurance Agency PHONE (591) 687-1117 w Not. (541)142-8290 WCN P O Box 10167 oAIL Ess.rnarcy@wardinsurance.net INSURERS), AFFORDING COVERAGE NAIC a Eugene OR 97440 ' INSURERA:S ecial Districts Assn. of Ore INSURED INSURER B: Rogue Valley Council of Governments INSURER C: PO BOX 3275 INSURER D: INSURER E Central Point OR 97502-0011 INSURER F: COVERAGES - CERTIFICATE NUMBER:13/14 GL/AL/EX-AI 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. INSR DL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MIDONYYY MMDD A GENERALUABIUTY BP44372-429 1/1/2013 1/1/2014 EACH OCCURRENCE $ 500,000 DAMAGE 10 1 X COMMERCIAL GENERAL LIABILITY P REMISES Ea occunence S CLAIMS-MADE Fx-]OCCUR MED EXP (An one person) $ PERSONAL 9 ADV INJURY $ GENERAL AGGREGATE $ None GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG E 17 POUCY PRO- OC $ IFCT A AUTOMOBILE LIABILITY.- ...BP44372 429_.. 1/1/2013 1/1/2014 COMBINED SINGLE LIMIT 500 000. Ee accident Ix ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY (Per acddentl $ AUTOS AUTOS X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Underinsured motorist $ A UMBRELLA LIAR X OCCUR 8P44372-429 1/1/2013 /1/2014 EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DEO RETENTION E $ LIM WORKERS COMPENSATION WC 9TAT0- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOWPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CITY OF ASHLAND, ITS OFFICERS, EMPLOYEES AND AGENTS ARE NAMED AS ADDITIONAL INSUREDS WITH RESPECTS TO WORK PERFORMED BY THE ROGUE VALLEY COG, SUBJECT TO TERMS S CONDITIONS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ASHLAND ACCORDANCE WITH THE POLICY PROVISIONS. KATHY GRIFFIN CITY HALL AUTHORIZED REPRESENTATIVE ASHLAND, OR 97520 Paul Jensen/DANAK ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005) 01 The ACORD name and logo are registered marks of ACORD