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HomeMy WebLinkAboutInsurance Certificate: WinterSpring Center OP ID: SAW CERTIFICATE OF LIABILITY INSURANCE oaTE(Mnvoovwv) 0710112013 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 Phone: 541-773-5358 CONTACT NAME, Protectors Insurance, LLC PHONE FA% Pilot Rock Ins Agency LLC (CA) Fax: 541-772-1906 prC No Ext: A/C N0: PO Box 4669 E-MAIL ADDRESS: Medford, OR 97501 PRODUCER WINTE4 Karol M. Igou c ST0.ER,,,: _ INSURER(S) AFFORDING COVERAGE _ NAIC0 INSURED WinterSpring Center INSURERA:Great American Insurance Comp. Transforming Grief & Loss INSURER B: PO Box 8169 Medford, OR 97501 INSURER C : INSURER D : INSURER E : INSURER 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 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 aDD SUER VOUCYEFF POLIOYEXP LIMITS Lm TYPE OF INSURANCE RJV. 1 POLICY NUMBER IMMrIDOPFYYYI~ MMIDD GENERAL LMBIUTY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X PAC8639497 1010112012 1010112013 PREMISES Ee dm rrenm $ 100,00 CI-AIMS-MADE r-;-1-1 [ ~ J OCCUR MEDEXP(Anyone,.,.r) $ 5,00 X Professional PAC8639497 1010112012 1010112013 PERSONAL B ADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 1,000,00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 1,000,00 POLICY PRO. LOG Prof $ 1,000,00 AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ (Ee accident) ANY AUTO BODILY INJURY (Per eemm) $ ALL OWNED AUTOS BODILY INJURY (Per amdenl) S 300,00 SCHEDULED AUTOS PROPERTY DAMAGE A X HIRED AUTOS PAC8639497 1010112012 '1010112013 (P.r.raid.rq $ A X NON-0WNEDAUTOS (PAC8639497 1010112012 1010112013 $ E UMBRELLA Mae OCCUR EACH OCCURRENCE $ EXCESS LIMB CLAIMSNAOE AGGREGATE E DEDUCTIBLE $ RETENTION E $ LIMITS WORKERS COMPENSATION WC STATU- OTH- ANO EMPLOYERS' LIABILITY T YIN ANY PROPRIETOR R/E%ECUTNE E.L. EACH ACCIDENT E OFFICE ER EXCLUDED? NIA (Mantlat., tory I. in NH) E.L. DISEASE -EA EMPLOYEE $ N yes, desaiM urger DESCRIPTION OF OPERATIONSWI. EL. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANacN ACORD 101, Additional Remark. SLMd.I., If.. apace la rsquirW) The City of Ahelaad its officers, employees and a ents are Additional Insureds for Genera Liability per CGR224-1201 attached. CERTIFICATE HOLDER CANCELLATION CITYAS2 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland, OR 97520 AUTHORIZED REPRRE'S,EENNTATIIVE ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of AGORD ,