HomeMy WebLinkAboutInsurance Certificate: ACCESS
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,4coR°® CERTIFICATE OF LIABILITY INSURANCE 6/30/2013
III 0/2013
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 endorsements .
PRODUCER NACONTACT ME Sandy Orr
Beecher Carlson Insurance Agency LLC (541) 772-1111 FA
MIC, X . 1541) 772-3785
3256 Hillcrest Park Drive PHONE .sandy.orrLlbeechercarlson.com
INSURER(S) AFFORDING COVERAGE NAICa
Medford OR 97504 INSURER A-Philadel hia Indemnity Ins Co 18058
INSURED
INSURER B:
ACCESS INSURER C:
3630 Aviation Nay INSURER D:
INSURER E:
Medford OR 97504 INSURER F:
COVERAGES CERTIFICATE NUMBER:2013=14 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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADOL SUER POLICY EFF POUCYEXP
LTR POLICY NUMBER MMID LIMITS
GENERAL LIABILITY EACH CCCURRENCE f 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea acarrence $ 100,000
A CLAJMSMADE ®OCCUR X PHM1044045 11/2013 /1/2014 MEDEXP(Anyorreparson) S 5,000
PERSONAL BADV INJURY $ 1,000,000
GENERR AGGREGATE f 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COMMP AGG $ 2,000,000
X POLICY PRO- LOC $
JECT
AUTOMOBILELIABLITY 1 000 000
A X ANY AUTO BODILY INJURY (Per person) S
ALL OWNED SCHEDULED PHPK1044045 /1/2019 /1/2014 BODILY INJURY (Per acdden0 S
AUTOS R AUTOS
NON-OWNED PROPERTY DAMAGE 4
HIRED AUTOS AUTOS racdd
Undarinsured nMrist $
X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,000
A EXCESS LIAR CLAMS-MADE AGGREGATE $ 5,000,000
OED X RETINTI01\14 10,00 DRUn427372 /1/2013 /1/2014 =
WORKERS COMPENSATION WC STATU7 OTH-
AND EMPLOYERS' LIABILITY Y I N RY UNITS SR
ANY PROPRIETORMARTNEWEXECUTIVE ❑ NIA E.L. EACH ACCIDENT $
OPRCERMEMBER El(CLUDED9
(Mandatory in NH) E.L. DISEASE - EA EMPLOY S
II yes, descriha under
DESCRIPTION OF OPERATIONS Ixti. E L DISEASE - POLICY "MIT S
A Property coverage MPK1044045 /1/2013 /1/2014 Banket BaMEings $15,174,270
Blanket EPP $807,850
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD IN, Additnal Reme" Schedule, N mom space Is requlretl)
Certificate holder is an additional insured as respects General Liability as required by written contract
per endorsement attached. This form is subject to policy terms, conditions and a clusions.
CERTIFICATE HOLDER CANCELLATION
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.
its officers, euployees 6 agents
Attn: Kristen Bakke AUTHORIaD REPREWNTATIYe
20 E Main Street
Ashland, OR 97520 B Pinkhmn/SAHDOR
ACORD 25 (2010105) ®1888-2010 ACORD CORPORATION. All rights reserved.
INS026 (mlixe).ol The ACORD name and logo are registered marks of ACORD
PFMP'
Additional Named Insureds
Other Named Insureds
Access Development Corporation Corp Non-Profit organization, Additional Named Insured
ACCESS, Inc. 403(6) Plan Additional Named Insured
Conifer Gardens Limited Partnership Additional Named Insured
I
OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC