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Home My WebLink AboutInsurance Certificate: AT&T Corp '``moo CERTIFICATE OF LIABILITY INSURANCE DATE`M01D°"""" 0521/2013 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 Marsh USA Inc. NAME: 701 Market Sheet, Suite 1100 PHONE FAX St. Louis. MO 63101 E-MAIL aC No Attn: ATT.CertRequest@marsh.com ADDRESS: INSURERS AFFORDING COVERAGE NAICa 018566-GAW-CRT-13-14 X X INSURER A: Old Republic Insurance Co 24147 INSURED AT&T Cory INSURER B : . One AT&T Plana INSURER C : 208 South Akard Street ROOM 2731 INSURER D: Dallas, TX 75202 INSUflER E: INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-004548956-03 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 LIP TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YVYP LIMITS A GENERAL LIABILITY MWZY 60244 06101/2013 0610112014 EACH OCCURRENCE S 1,000.000 X COMMERCIAL GENERAL LIABILITY PREMISES We occurrence) $ 1.000,0(p CLAIMS-MADE M OCCUR MED EXP An one person) $ NIA PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ I0,D00,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 1,000,000 X POLICY LOC $ ECT A AUTOMOBILE LIABILITY MWTB 21932 06/01/2013 0610112014 COMBINED SINGLE LIMIT Ea awidenll 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident $ HIRED AUTOS NN~OSWNED PROPERTY DAMAGE $ H - $ Per soccer, UMBRELLA DAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DELI RETENTION$ $ A WORKERS COMPENSATION MWC 11847300 061012013 06101/2014 X WC STATU- S AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER E%CLUDED7 N/A (Mandatory in NH) E.L. DISEASE-EA EMPLOYE $ 1.000.000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICYLuvT $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS (VEHICLES (Attach ACORD 101, Additional Remarls Schedule, if more space is required) Re: Cmtract OISD/10014382. Address: Medford, Medford OR 97503-0000 The Cry of Ashland and its elected and appointed officers, officials, agents and employees are included as Additional Insured under the General Liability and Automobile Liability policies but only with respect to the requirements of the contract between the Ceniflcale Holder and the Insured. CERTIFICATE HOLDER CANCELLATION Cityol Asltland SHOULDANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Administrative Services, Ref: Cost If 000027 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 E. Main St. ACCORDANCE WITH THE POLICY PROVISIONS. Ashland, OR 97520 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee S4eLxaot..: .c. ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 018566 _ LOC St. Louis ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. AT&T Corp. One AT&T Plaza POLICY NUMBER 208 South Akard Street Room 2731 Dallas, TX 75202 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Coverage evidenced applies to Subsidiaries of AT&T Inc., EXCLUDING Pacific Bell Telephone Company, Nevada Bell Telephone Company, Southwestern Bell Telephone Company, Illinois Bell Telephone Company, Indiana Bel Telephone Company, Michigan Bell Telephone Company, The Ohio Bel Telephone Company, Wisconsin Beg, Inc., The Somhem New England Telephone Company and BellSouth TekrvnmuNcaliau, LLC, WITH THE EXCEPTION OF Workers' Compensation. ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Rsk Managemerrt AT&T Services, Inc. One AT&T Plaza 208 South Akard, Suite 2731 Dallas, TX 75202 May 21, 2013 To Whom It May Concern: Subject: Subsidiaries of AT&T Inc. Certificates of Insurance (COI) Memorandum of Insurance (MOI) You are receiving this because you have been identified as a Third Party who has requested a Certificate of Insurance from an AT&T Entity. AT&T has currently renewed its' Casualty Coverage(s) for the 6/1/13 -6/1/14 policy period. IGndly note, AT&T also provides a Memorandum of Insurance (MOI) for Third Parties. Please take a moment to access the website below and review the information. If the MCI satisfies your organization's requirements and the COI is no longer required, please indicate on the front of the Certificate and fax to: 212-948-4341. https://www.marsh.com/moi?ciienl=D526 If the COI is still necessary and requires modifications, please contact the AT&T employee responsible for your business relationship and ask that employee to authorize the necessary updates by following their standard request protocol. COI's will only be sent or modified when requested by the AT&T employee responsible for the business relationship. This would also include COI renewals. Thank you for assisting Subsidiaries of AT&T Inc. Sincerely, AT&T Services, Inc. Disk Management IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancellation of insurance provided hereunder by adding the following: A. In the event this policy is cancelled for any permissible reason, other than for nonpayment of premium, we shall endeavor to provide advance written notice of cancellation to certificate holders set out in the schedule on file with the Company, after notifying the first Named Insured of such cancellation. Notice of cancellation to certificate holders may be made by any commercially reasonable means, including mail, electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancellation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancellation date, nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. PIL 029 10 10 MWn9 21932 AT&T Inc. 0610112013- 0610112014 IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancellation of insurance provided hereunder by adding the following: A. In the event this policy is cancelled for any permissible reason, other than for nonpayment of premium, we shall endeavor to provide advance written notice of cancellation to certificate holders set out in the schedule on file with the Company, after notifying the first Named Insured of such cancellation. Notice of cancellation to certificate holders may be made by any commercially reasonable means, including mail, electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancellation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancellation date, nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. PIL 029 10 10 M WZY 60244 AT&T lnc. 0610112013 - 0610112014 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY : WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY NOTICE OF CANCELATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancelation of insurance provided hereunder by adding the following: A. In the event this policy is canceled for any permissible reason, other than for nonpayment of premium, we shall endeavor to provide advance written notice of cancelation to certificate holders set out in the schedule on file with the Company, after notifying the Insured first named in item 1 of the Information Page of such cancelation. Notice of cancelation to certificate holders may be made by any commercially reasonable means, including mail, electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancelation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancelation date, nor negate cancelation of the policy. All other terms and conditions of this policy remain unchanged. PC0101010 AT&T Services, Inc., and Affiliates MWC118473 00 Policy Term: 6-1-13 - 6-1-14