HomeMy WebLinkAboutInsurance Certificate: Ashland Gallery Association
CERTIFICATE OF LIABILITY INSURANCE . OP ID DR 0 4:"12 DATE DDYYY~
5 13
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 CONSTirUTEACONTKAC4" FTWEEN`THE ISSUING INSURER(S), AUTHORIZED -
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: the certificate holder Is an ADDITIONAL INSURED, the poll es 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 Hsu of such endorsament(a .
PRODUCER E;
PHONE
Insurance Marketplace, Inc. AID NO:
1998 Skypark Or Suite 100 AD REBS:
Medford OR 97504 'OSTo=IO e: ASFQ,A-5
Phone:541-779-0177 Fax:FAR 772-8235 INSURER(S) AFFORDING COVERAGE NAICe
INSURED ' INSURER A: Ca itol Insurance Co
Ashland Gallery Association INSURER B:
John Davis
Ashland OR197520 INSURER C:
INSURER D :
' INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THATTHE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIM
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMFNTWRRR RESPECT TO WHCH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEBJ REDUCED BY PAID CLAIMS.
NR TYPE OF INSURANCE INSR =1 POLICY NUMBER MMuD OUDDN"yyy) UNITS
GENERAL LIABILITY EACHOCCIIRRENCE S1,000,000
A R COMBIF,RCAL GENERAI. LIABILITY CP02215132-01 - 03/31/13 03/31/14 PREMISESEe Wtawrem $1,000,000
CLAIM35-0ADE®-OCCUR. MED EXP(Any one pawn) $10,000 ,
g PERSONAL S ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GFNL AGGREGATE LIMIT APPLIES PER PRODUCTS -MW/CP AGO $2,000,000
POLICY JPRO- Loc $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMB 3
(Ea accident) .
ANY AIIm' BODILYULIURY(Par Person) S
ALL OWNED AUTOS - BODILY INJURY O'er accident) S
SCHEDULED AUTOS PROPERTY DAMAGE 3
HIREDAUTOS (Per aoddent)
NDNOWNED AUTOS 3
$
UMBRELLA UAB OCCUR EACH OCCURRENCE $
BOCF98 LAB CLAIMSMADE AGDREOATE S .
H DEDUCCIISLE $ .
RETENTION S 5
c MP TION RY LelrTB VIK-
ER
-
AND EMPLOYERB• LIABILITY YIN
IA U. EACH ACCIDENT 1;
OOFFICCEMMEMBERF.XCLU~ED4 C=
(Mandai" EI NH) E.L. DISEASE- EA EMPLOYEE S
n yye0tt,, dmulba
OFbCP'JT N =Ier
OF F OPERATIONS W. EL DISEASE-POLICY LIMB S
DEBCRIPTIDNOFOPEWATIONSILOCATIC SIVEHICLES (AtaohACOR3Ie1 AddNonal Remarks Scheeale Mmonapxals~nv IUrapq~O)
City of Ashland aad its officers, emptOyeee and agen~s are tlonal
insureds.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
DIRBCTO THE EXPNATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISION&
City of Ashland _
Director of Finance AUTHORRPn R63MSENTATIVE
20 B. Main St.
Ashland OR 97520 R. Scott Weaver, CIC
• ®193&2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD