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HomeMy WebLinkAboutInsurance Certificate: Community Works A~ CERTIFICATE OF LIABILITY INSURANCE F 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 Beecher Carlson Insurance Agency, LLC CONTACT NAME: Beecher Insurance 220 NW 2nd Avenue, Suite 8010 PHONE AI to d: 2 -1 1 F an No: P503-274-0323 ortland, OR 97209 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICN www.beechercadson.com INSURER A: AJIjance of Nonprofits for Insurance INSURED INSURER B : Community Works 201 W Main, Suite 3D INSURER C: Medford OR 97504 INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 16902167 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 TYPE OF INSURANCE JUM ADOLSUBR POLICY NUMBER MwoCYEFF MMUDrfYY LIMITS wyor TR A GENERAL LIABILITY V 2013-19517 7/1/2073 71112014 EACH OCCURRENCE E 1,000,000 COMMERCIAL GENERAL LIABIUTY PREMDANA S( EeoccurtRENTEDence $ 100,000 I S CI-AIMS-MADE 10 OCCUR MED EXP(Any one person) E 10.000 J Professional Liability PERSONAL B ADV INJURY E 1,000,000 J Abuse & Molestation GENERAL AGGREGATE E 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG E 2,000.000 POLICY PRO LOC E JECT A AUTOMOBILELIABILITY 2013-19517 7/1/2013 7/1/2014 MBINEO151NGLE LIMIT E 1,000,00 ANY AUTO BODILY INJURY(Perpelson) S AUTOSMED SCHEDULED BODILY INJURY (Per actldent) $ HIREDAUTOS NON-OWNED (P Rar aka DAMAGE E E S UMBRELLA LIAB OCCUR EACH OCCURRENCE E EXCESS EMUS CLAIMS-MADE AGGREGATE E DED RETENTIONS E E s WORNERS COMPENSATION YSC STATU- %T~1- ANDEMPLOYERS'LWBILITY YIN TORY LIMITS ANY PROPRIETOWARTNE"EXECUTIVE E. L. EACH ACCIDENT E OFFICERIMEMBEft EXCLUDEDO NIA (Mandatory In NH) E.L. DISEASE-EA EMPLOYEE I If yes, desmbe under DESCRIPTION OF OPERATIONS below E. L. DISEASE-POLICY OMIT S DESCRIPRON OF OPERATIONS I LOCATIONS I VEHICLES uUtach ACORD 101, Addi ldnal Remarks Schedule, N mon apace la rallulrad) Al operations of the Named Insured as provided under the policy terms, conditions 8 exclusions. General Liability Coverage includes Blanket Additional Insured Coverage as required by written contract per endt CG 20 26 07104 (Attached). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF ASHLAND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: FINANCE ACCORDANCE WITH THE POLICY PROVISIONS. 20 EAST MAIN STREET ASHLAND OR 97520 AUTHORUuD REPRESENTATIVE MED San L. Orr ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CExT NO.: 16303167 (NFO) Sandy L. Orr 7/1/2013 4:05:14 PM Page 1 of 2