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HomeMy WebLinkAboutInsurance Certificate: Southern Oregon Transportation SOUTH03 OP ID: SAW I DAT03/EIM112013 CERTIFICATE OF LIABILITY INSURANCE 11/2013 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 endorsement(s). PRODUCER CONTACT Phone: 541-773-5358 NAME: Sheryl Wirts Protectors Insurance, LLC Fax: 541-772-1906 PHONE 541-842-2968 Fax Pilot Rock Ins Agency LLC (CA) aC No Ert: ac No:541-772-1906 PO Box 4669 noDaEss: shreylw@protectorsins.com Medford, OR 97501 Karol M. Igou INSURERS AFFORDING COVERAGE NAICC INSURERA: CNA Continental Casual Co INSURED Southern Oregon Transportation INSURER a: National Fire Insurance Engineering LLC 112 Monterey Dr INSURER C: Medford, OR 97504. INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 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 TYPE OF INSURANCE AO POLICY EFF POLICY EXP LTR POLICY NUMBER MWDD/Y MMn/D/VYrr LIMITS GENERAL DABIDTY EACH OCCURRENCE $ 1,000,00 A COMMERCIAL GENERAL LIABILITY X 84018108107 03/15/2013 03/1512014 PREMISES Ea oLCUnenee $ 300,00 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,00 X Business Owners PERSONAL a ADV INJURY $ GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $ POLICY PRO- LOC $ JFQT COMBINEINED SINGLE LIMIT AUTOMOBILE I-MBIDTY Ea nl 1,000,00 B X ANYAUTO X 64018108110 03/1512013 03115/2014 BODILY INJURY (Per person) $ All OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS Me CLAIMS-MADE AGGREGATE $ DEO RETENTION$ $ WORKERS COMPENSATION WCSTATU- DER EMPLOYERS' LMBILRY Y I N T ANY PROPRIETORIPARTNERt ECUTIVE ❑ E.L. EACH ACCIDENT $ OFFICE"EMBER EXCLUDED? NIA (Mandatory In NH) E. L. DISEASE-EA EMPLOYEE $ I( yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ A Professional Liab MCH288263850 03122/2013 03122/2017 Cccur. 1,000,00 Agg. 1,000,00 DESCRIPTIONOFOPERATIONSILOCATIONSIVEHICLES (Attach ACORDIDt,AdddionelRemade Schedule,Bmorespace Ismquirt ) The City of Ashland and it's elected officials, officers, employees are additional insureds:FOR GENERAL LIABILITY:Priaiary non Contributory per SB300176BO108;30-day SB147052AO306 Per attached FOR AUTO LIABILITY: Per CA2048-02 99 6 30 day G300660 Per Attached Primary per CA0010310 CERTIFICATE HOLDER CANCELLATION CITYAS2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Str Ashland, OR 97520 AUTHORIZED REPRESENTATNE ©1988.2010 ACORD CORPORATION. All rights reserved. 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