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Insurance Certificate: Ashland Housing Opportunities
DATE (MN/D T"_" I A`~ CERTIFICATE OF LIABILITY INSURANCE 0 312 712013 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. 1. IMPORTANT:11fllhejcerORcate holder is an,ADDIT10NAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to-'- - thel terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate, doe not confer rights to the..... certificate holder in lieu of such endorsement(s). - - - PRODUCER( Phone: 50336&7001 Fax: S 6&7354 DOWACT SISKIYOU INSURANCE MARKEfPL'ACE_(GP)' _ NWE MID VALLEY GENERAL AGENCY LLC I ' I PHONE 'L IFA%.'- 1541-474-66632 , I Luc w,€sm 1541-479-6672 I=- E-MAIL 4305 RIVER ROAD N _ SS: VANETTA@SISKIYOUINS.NET KEIZER OR 97303 PRODUCER 2690 - CUSTOMER..: Agency Lice: 100159512 INSURER(S) AFFORDING COVERAGE NAICe INSURED INSURERA : SCOTTSDALE INSURANCE COMPANY ASHLAND HOUSING OPPORTUNITIES, INC. 1215 SW "G" ST. INSURER B GRANTS PASS OR 97526 INSURERC INSURER.' INSURER E NSURERF COVERAGES CERTIFICATE NUMBER: 55005 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, INSR AWL SUER I'MICYEFF MLMYEXP LIMITS LM TYPE OF INSURANCE INSR MID POLICY NUMBER (MMmDNYYY)__flMhUDDNYYYf_ A GENERAL LIABILITY CPS1705618 03131113 03131114 EACH OCCURRENCE $ 11000,000 ' GETO RENTED $ 100,000 - PREMISES_(Ee orn,ewl_ X COMMERCIAL GENERAL LIABILITY 6 CLAIMS-MADE A (OCCUR MED. EXP(Any one person) 5,000 - - t - PERSONAL S ADV INJURY 1,000,000 _ _ _ GENERAL AGGREGATE $ 1,000,000 GEN-L AGGREGATE LIMIT APPLIES PER.:" •T - , PRODUCTS - COMPIOPAGG $ 1,000,000 Y POLICY tPR0. - LOC. i AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ (Ea acddentl ANY AUTO BODILY INJURY (Per pereon) $ ALL OWNED AUTOS BODILY INJURY (Per aaidenl) $ SCHEDULEDAUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per amdent) NON NEDAUTOS $ E UMBREw LMe OCCUR EACH OCCURRENCE EXCESS UIM CLAIMS-MADE AGGREGATE DEDUCTIBLE $ RETENTION $ $ WC STATU- OT1 $ WORKERS GOY-TORYLIMITS AN. EMPLOYERS' ' LIABILITY Y/N ANY PRONNEXEGUTNE E.L. EACH ACCIDENT $ OFFICEeIMEMBEREMBER EXCLUDED? N/r` _ E.L. DISEASE-EA EMPLOYEE (Ltmaelory in NHI DESORPTION NOFo E.L. DISEASE-POLICY LIMIT $ OF OPERATIONS eebw DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Romance Schedule, If more apace Is required) 1971 SISKIYOU BLVD, ASHLAND, OR 97520 CERTIFICATE HOLDER LLATION S LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF ASHLAND T EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 EAST MAIN STREET A RDANCE WITH THE POLICY PROVISIONS. ASHLAND, OREGON 97520 APR - 1 2013 - no REPRESENTATIVE Attention: ROBERT D NELSON MID ALLEY GENERAL AGENCY LLC , erman Rvbeis°" ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD