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HomeMy WebLinkAboutInsurance Certificate: Rogue Farm Corps 412073 Acc CERTIFICATE OF LIABILITY INSURANCE °706/004/2013 0 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 NCAONMTE~CT Dyan Bates FAX Evergreen Insurance Managers Inc ( PHONE 503) 616-7900 A/C No(503) 259-3065 : 5293 NE Elam Young Pkwy Ste 160 ADDRESS:Xtdbates@evergreeninsmgrs.com INSURER(S) AFFORDING COVERAGE NAIC9 Hillsboro OR 97124 INSURER A: Acceptance Casualty Insurance Company INSURED - INSURER B: Rogue Farm Corps INSURER C: PO Box 533 INSURER D SURER E Ashland OR 97520 INNSURER F: COVERAGES - CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INS POLICY NUMBER (MMIDDAWY) MIDDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY P EMIS e a curtence $ 100,000 CLAIMS-MADE ERIOCCUR MED EXP (Any one Person) $ 5,000 A Y CLOO106407 06109/2013 06/0912014 PERSONAL BADV INJURY $ 1,000,000 GENERALAGGREGATE S 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS -COMPIOPAGG $ Included K POLICY PRO- OC $ Pr.T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANYAUTO BODILY INJURY (Per Person) $ ALLOWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS AUTOS HIREDAUTOS NOWOWNED PROPERTY DAMAGE $ AUTOS Peracident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION$ $ WORKERS COMPENSATION WC STATU- 0TH- ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ NIA E. L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EAE MPLOYE S Ir yes, describe under DESCRIPTION OF OPERATIONS W. -E.L DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Ashland, Its Officers and Employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Finance Dept Attn: DLTuneberg, Director ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main St AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD