HomeMy WebLinkAboutInsurance Certificate: WinterSpring Center
WINTE4 OP ID: SAW
° CERTIFICATE OF LIABILITY INSURANCE 09130 ° /2013
09/30
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(les) 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 endorsemen a .
PRODUCER CONTACT
Phone: 541-7735358 NAME; Sheryl Wins
Protectors Insurance, LLC Fax: 541-772-1906 PxoNE FAl(
Pilot Rock Ins Agency LLC(CA) Ne -541-842-2968 Arc No;541-772-1906
PO Box 4669 • EA D ess: sherylw@protectorsins.com
Medford, OR 97501
Karol M. Igou - INSURER(S) AFFORDING COVERAGE NAIC A
INSURER A: Great American Insurance Comp.
INSURED WinterSpring Center INSURER e:
Transforming Grief & Loss
PO Box 8169 WsURER c
Medford, OR 97501.0469 INSURER D:
INSURER E :
NSURERF:
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 POLICY EFF POLICY UP
LTR 7ypE OF INSURANCE POLICYNUMBER IMMfDDfYYYY) (MhUDDrYYYYI LIMITS 1= A= GENERAL LIABILITY EACH OCCURRENCE f 1,000,00
A X COMMERCIAL GENERAL LIABILITY X PAC8639497 1010112013 10/0112014 PREMISES Ea azurrenca S 100,00
CLAIMS-MADE FXJ OCCUR MEDUP (Artyonepagan) f 5,00
PERSONAL S ADV INJURY $ 1,000,00
GENERAL AGGREGATE S 1,000,00
GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S 1,000,00
17 POLICY PRO-
JFQ.T E-1 LOC - S
AUTOMOBILE LUIBBITY COMBINED SINGLE LIMIT
Ea eccidera
ANY AUTO BODILY INJURY (Pm pmson) $
A AUTOS HIRED AUTOS NON-OWNED E $
ALLOOWNED SCHEDULED . UA7GGREGATE er aoiderd) f
AUTOS S
UMBRELLA LIMB OCCUR CE S
EXCE38 LUU3 CLAIMSMADE S
LIED RETENTIONS S
WORKERS COMPENSATION OTH-
1MrrS
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORRARTNER/EXECUT NE E.L EACH ACCIDENT f
OFFICERIMEMBER EXCLUDEDT F-1 NIA
IMendalory In NH) E.L. DISEASE - EA EMPLOYE $
If deavibe,sder
DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AWn,h ACORD 101, AddSional Remo , Schedule, N more spew Is requlreM
The City of Ashland, its officers, employees and agents are Additional
Insureds for General Liability per CG8224-1201 attached. .
CERTIFICATE HOLDER CANCELLATION
CITYAS2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City ACCORDANCE WITH THE POLICY PROVISIONS.
20 E Main Street
Ashland, OR 9752D AUTHORZED REPRESENTATIVE
e''~j~ryyL WGUv
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