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HomeMy WebLinkAboutInsurance Certificate: Oregon Shakespeare Festival (2) F (MM/DDYYYY) CERTIFICATE OF LIABILITY INSURANCE D 1/14/2013 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. 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 endorsements . PRODUCER CONTACT NAME: Pam Breazeale Beecher Carlson Insurance Agency LLC PN IC N ONE. (541)494-2655 FAX .(541)19.-2)55 707 Murphy Rd E-MAIL pam. breaz ea l e@beeche rcarl son. com INSURERS AFFORDING COVERAGE NAIC It Medford OR 97504 INSURERA:Great American Insurance Co 16691 INSURED INSURERB:Great American Alliance Ins Co 6832 Oregon Shakespeare Festival INSURER C: PO BOX 158 INSURER D: INSURER E Ashland OR 97520 INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 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 UBR LTR TYPE OF INSURANCE i.a. VD POLICY NUMBER MMMDY YEFF YY MM D POLICY EYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMA OR N ED PREMI E E rr nce $ 100. 000 A CLAIMS-MADE I X1 OCCUR X AC8049553 1/1/2013 1/1/2014 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN•L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINEDISINGLELIMn 11000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AP804955404 1/1/2013 1/1/2014 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-0WNED PROPERTY DAMAGE AUTOS P r acci n $ UMBRELLA LIAB X PIP-Basic $ 15 000 OCCUR EACH OCCURRENCE $ 10, 000, 000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DELI X RETENTION$ 10,00 804955504 1/1/2013 1/1/2014 $ WORKERS COMPENSATION WU OANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOWPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMSER EXCLUDED? ❑ NIA (Marbatory In NH) E.L. DISEASE - EA EMPLOYE - - ' yes, tl25ui'a Ontle! DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule. H more apace Is required) Certificate holder is an additional insured as respects General Liability when required by written agreement per form # CG2010 (07/04). 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, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. • Its Officers, Employees and Agents Attn: Bryn Morrison AUTHORIZED REPRESENTATIVE 20 E Main Ashland, OR 97520 Pam Breazeale/PAMBRE /2-A ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organlzatlon(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" 11property damage" occurring after: caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts equipment furnished in connection with such h 2. The acts or omissions of those acting on your work, on the project (other than service, behalf: maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © 130 Properties, Inc., 2004 Page 1 of 1