HomeMy WebLinkAboutInsurance Certificate: Ashland School District 5
GLAL Certificate Summary Certificate Page 1 of 2
GENERAL LTABILIT; s7. AUTO LIABILlIrV ADDITIONAL. PARTICIPANT CERTIFICATE
AGENCY/AGENT- ISSUING CERTIFICATE Oats: 7/52/201] Met
THUS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGMfS UPON TR CERTIFICAIE HOLDER
BMner Cohan RMIMM AgurKr MOMS OTHER THAN TtOSE PROVIDED N THE COVERAGE OOCVMINIS.
707 Murphy Rand THIS CERTIFICATE DOES NOTAMEND, EITEND OR ALTER THE
Medford, OR 97514 COVERAGE AFFORDED BYTHE COVERAGE DOCUMENTS LISTED
Sandy Or HEREIN. THIS CERTIFICATE DOES NOT CONSIME A CONTRACT
(541) M-1111 BETWEEN ANY OF THE FOLLOWING PARTIES: THE AGENCY, NAMED
MRTIIPAMT, CERTIFICATE I R AND/OR MMPMRS
AFFORDING COVERAGE
NAMED PARTICIPANT/MEMBER- REQUESTING CERTIFICATE ORGANIZATIONS AFFORDING COVERAGE
Ashland Schad Obeid 05 ~-~--•~4w
SOS Sbby" awkward CamparvA • ROOrIV CaRgOy Cpere% Wr EORatbn (PAC1:)
Ashland, OR 97520.2197 eampm7 B - Gonads hmaaca cempay
Alta Charter;
(341)482.2611
COVERA099
iRbbberlWtledrpwaee D00umera kb Edtwebtwob;wr weedtp;a Nand Pwtkloa Iwr;n br M&Cpaa9epared srdlcslad IbariQaagey ant'
re4utenianL term a mrdRW aFery caWart c, caner daaenpe Mrrepeat t0~ Bra Waf,,e mpMwp,W a ma, patch eve a 49e Nwdad;y Me
Cowa2e Ooaauer6 NRAMaM b
b rAwbey or n are fermi an and aatlubw Cmeraye OOa4nwew. Apwepaw Lbvb w/tlOr d Inrua'/lere
ar faa,cedMoab Ram; Sunsa the edwrahrmined erReO VMer Ileadtov", epa n Mateo adeb H aaper4aK4 drderenta erNNdl rove Ib doueea Yr
ay waY m hrN p YI;w caw Wp6pe fe rK.Or Vp/ IOIafO.
Elryitatiow
OR/CO Two of CmreraBa Caverago effective Data
LiR Decumard yM Limlb
General us" ;emnApaawN IMMAM.=
x jaaemwaatdsnerduaent,
% irrAaco"MuwaaN iz7naM•ta avmN 3
A x jtaWermd!IPreorwlwmn 1 -
6 % iermdRe ram ._._-..r.~...-._. Hiap o¢wnrRf tte•000,000 1
cvbalmrar ktb =gn I a OF50.o00
~lddut VW*y DaaadPADR: $50.000
']3,000 Mvirnien do&cdbb for t4nnhatbrs N PALE w N cd Ned c;urael b rw mrNWed
Pew to an arabymmt wrardbT.
Automo011o LIa0NRy award ASwwN tw,aao oop
x saraea.eRUwF
i
x IwsewesaNm-O.rceeamT zxams4. w 7Itg01: nlepu !
X .....-.....i......._.._.. ' am ccv,ar. 7re.umwu i
iow..aw Ptm, aw
x 7de0eerUFllr: MOM, - I
ewmelu: wlrrrat7aW ty w•avuJ Wmgl tvanlltalmM7 isr41aYMWWrae4 a, reyabWVxvrVm. rawleq WlwM~mlrra4ass. WrMIP4area- .
r7ahrw AR Badb MAa7.Owwb Denepe a Pamd NrYY were ea wernC pmlkam4 tl Oean01 to two Iaemr. m ro ern[ dead caerge Orterd b err] Rely
therytLln, Su4a Aaiea7mwrdrviyC asv7leA atdnpwA dax CtlIALNa IabaY4 Sobnglltpenaa/w cry GbaA SuIIa Amm.IVdr wail pfaTb
the of" dClAbe Olarrrt er w eDeerner4
WaaWYn hwmW pdrhertem tIW Mnrurta was OawriRwl nrl IeaM aaiheAHn Mdrrya
Cwdfkab Helder - RapuesUng Certificate CMQLLATTON:roab any or the caenage Dean eMS Karam be morRDpdbefwa the
Oq d Ashland, TadRters 6 depbyeas G*Mt en date Nand. PACE WE ndearwto prOdde natke In acardence IRAN the PACE
20 fast Mnn Street Gonad UaEpBy Carwno Dacument pravbbm Rdkwn to nwA such natln shall Impoto
Atidand, OR 97520 NO 011106nn aF NatnRY Of any Ihed upon PACE, Rs limb or reprmenb8vm, car tlMbPrC
anew emtmMa.5 /
Aetleww EdyRepimamrtlra d Named PMk#=L-
DAN:
r
GL-AL Certificate Summary Certificate Page 2 of 2
Applicable Coverage Docernnd DeUnkloom
The ftlbrAng deiWtlon are ProvWed sdely !or conwmerhceal rcferencoand droll not be dammed a any way to Unit or affect the provision to winch
may rdatq forcompisle dciaUS on me bans, condmorrs ad machaims of applicable Coverage Documents please refer tome PACE liability Coverage
Docomaht
Partfdpmt mean:
1. The Named Participant and each of the follerdng wMe acting within the coanse and mope of their dutles as such:
a. Member OF the Board;
b. eumptiws officers:
c Employees;
d. Volunbems and Agenis;
A. Regl and Sahdea t whom course study includes on-the-job training, but only while acting umber directions and vethln the scope W their
activities perlemad while In OalNng;
I. Student organizations, Parent Teacher Organization, Koester Clubs end Foundations under the judsdktim and mpeNslon of the governing
board; and
9. Pay person, entity oramy, organization the Named Partlcpant is required by an Inured COnbact to Include at a Participant. This comage Mg be
Bmkad to the edtyd OF coverage and Undo OF liability required by the insured Oman ct and YM net Increase the limas rated In SECTION V. -
MITTS OF WSILITyorafter any of the terms OF semi stood In this Coverage DoeuramG The insured Contract most be effectiv a and
executed pronto a omaed Oaiaminco w VQonghl AhL In nO mend shall coverage under this Coverage Dourmmt evmad many Patty for any
,Oalm horrevm or w6 emear= ftc1, waiting Out of sucb party's sale negligence. (1) The mm "Additional resume' 11 used In an gssatred Contract
shag be understood to mesn thesame m Additional Aanticlpand.
L With aspect m:
Mobga "inset or a" Auto, any person Is a Pamdpmt while driving such Auto or Mobile equipment with a Named FortGpanCs permhaion. Any
pesos, eddy, or agmbatba resparasthb forgwcoduct of such pawn is abo a Parttipanb bUt only with rasps[ be godly Injury or Prop®ty Damage
arising out of the opw&Um of the Auto err Mobda Equipment However, the owner wanyone also from whom a Named participant hires a b rmws an
Auto is a Parllclpant Only Ifthat Auto Is a uses, connected to an Auto a Named Participant amts. Morrow, m person, amity, ororganirallon is a
Partldpmd under this paragraph t. vein ra.pectto:
A. Property Damage to property owed by a Named Participant or the anloyar of my person W. b, a participant under this provision;
b. Any Auw a Named PwWpmt htm w benova hem are of a Nmod Participant's Employ, solunbers or mem dies of their households, it they
am the owns Of such Auto, alms acting vathes tin scopeof Vveir dutles on a Named Paticipwws beat!;
c. Any Auto being used are person errgloyed In tire bustnssof sdlrg, sbNdng, repalring, or parking Autrt udess may area Named hrtidpant'a
Employees; or
d. The movement of property to orlmrth an Auto merge[ a Named Pmttdpmt, a Named Participant's Employem, lassoes orbamvcrso meie Auto,
and any emptoyoe of the lases or borrwes.
InWtad Contrad mmm:
1. A legally anhcmblemrhtract that b%Wm we or all of the Moving:
a. A lame of pror4 m as N ndalaw to Out Debilities assumed by the Named Participant artlig on of the Tema, such asumptlm c corm; In writing
prbr to the date of Ommmco)
b. A aWa6mk agreement;
Q Anyem tor B=magr t;
d. An ahlgatlim, as required by oMnahce, to Inderma ya Public Body;
a An elevator mama agmem = .
I. That pet of any cUm contract or agreement pabinUg to ma Named Partkipamt operations (Idling an bdemWkatbn OF a Public edy an
camneedm with work pafarmd by ar for a P let: Body) under which the Named participant: assume the butBablity of mother person or mtlty
To pay for godly Indury, Pmperty Damage or Personal Injury to a third person erorgardzatlon, provided the Bodily Indury, Property Damage or
Personal injury Ocmre sohsequset to theeemcutlon of the oOntrectaragreamenC and
g. Contracts Fars -Ace yeah Public Bodies.
1Mlesured Contract does not Include that part of my contractor mgr waft:
A. That IdmaEtes an ardhDerl, egineaor surveyor acting man Independent contractor for injury or Damages arbbg out of profasbnal error
hromislaN•
b. That lndenmLles my person wargentmtion for Oameges by The to promises renbtl or, loaned to the participant;and
c mot invoke the pun fume orals d reel Property, a pumnal I mpwty.
Brill!