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HomeMy WebLinkAboutInsurance Certificate: St Vincent De Paul Beecher Carlson 6/25/2013 1:50:29 PM PAGE 1/013 Fax Server AC40R°® CERTIFICATE OF LIABILITY INSURANCE DATE1MMmomYY) 6/25/2013 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(tes) 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 Sandy Oxr Beecher Carlson Insurance Agency LLC PHONE (541) 772-1111 n No 1511)'!'12-30 B5 3256 Hillcrest Park Drive L .sandy;rr®beechercarlson.com NSURERS AFFORDING COVERAGE NAIC# Medford OR 97504 INSURERA:Philadelphia Indennit Ins Cc 18058 INSURED INSURER B: Rogue Valley District Council St Vincent de INSURER C: PO Box 1663 INSURER D INSURER E: Medford OR 97501 INSURER F: COVERAGES CERTIFICATE NUMBER:2013-2014 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. INS LTR TYPE OF INSURANCE INSR MD POLICY NUMBER LMIDdYYY MIAIOID!'YYY Libras GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 X COMMERCIAL GENERAL LIABILITY PREPAISEBEA occu.eme 5 100,000 A CWMSMADE OCCUR X PHPK1031928 7/1/2013 7/1/2014 Mm EXP(My one peso.) S 5,000 PERSONAL a ADV INJURY S 1,000,000 GENERAL AGGREGATE s 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER. PRODUCTS - COMB'OP AGG 5 2,000,000 X PCLICV PRO- LOC S AUTOMOBILE LIABILITY (Ez i NV 1,000.00 0 X ANY AUTO BODILY INJURY (Per prawn) 5 A ALLO.MED SCHEDULED PHPH1031928 7/1/2013 /1/2014 AUTOS ALTOS BODILY IN.0.1RY IPn auldenq 5 NON.OYVNED PROPERTY DAMAGE S HIRED AUTOS AUTOS Per ecdtlmt PPB vc S x UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 1,000,000 A EXCESS LIAB GLNMSMAOE AGGREGATE 5 1,000,000 DEO X RETFMIOnb ao,00p PHVB423696 7/1/2013 7/112014 s WORKERS COMPENSATION MSTATU- OTH- ANDEMPLOYERS' LIABILITY YIN ANY PRCPRIETCRPARTNERIE%ECUTIVE ❑ E.L. EACH ACCIDENT S OFICERMEMBER EXCLUDEM NIA (M.r,Jw.ry In NHI EL DISEASE- EA EMPLOY 5 If yes. tl6:nCt unCtl DESCRIPTION OF OPERATIONS W. EL DISEASE-POLICY LIMIT S DESORIPTIONOFOPERATIONSILOCATnNSIVEHICLBS (Atrmh ACORD 101, ACClUonal Remaft Schedule, If more space is rquled) The City of Ashland, its officers, officials, agents, volunteers and employees are additional insureds as respects General Liability when required by written agreement per attached endorsement- This form is subject to policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION (541)552-2059 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland, OR 97502 AUTHORIZED REPRESENTATIVE Mike Kastzoni/SAWCOR ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (zrixc ).D1 The ACORD name and logo are registered marks of ACORD