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HomeMy WebLinkAboutInsurance Certificate: Jackson Cty Child Abuse Task Force DATE (MMIDDrfYYYI Ac"Ro® CERTIFICATE OF LIABILITY INSURANCE 1111512013 14.~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE CERTICATEFOFB INSURANCE DOES NOTLCONSTITUTE A CONTRACT BETWEEN OTHER SSUINGF NSURER(S)TAUTHORZI BELOW. ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If 5UBR5 GATION 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 Brown $ Brown Northwest Insurance CONTACT NAME: I rr 3256 Hillcrest Park Drive PHONE - A.A Medford, OR 97504 E-MAIL ADDRESS: H °H on om INSURERS AFFORDING COVERAGE NAICI www.beechercadson.Lom INSURER A : INSURED INSURER B : Jackson County Child Abuse Task Force INSURER C: Children's Advocacy Center of Jackson County INSURER 0: 816 W 10th Street Medford OR 97501 NSURER E: INSURER F CERTIFICATE NUMBER: 18370807 REVISION NUMBER: COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERT ACT OR OTHER CERTIFICATE MAY NOTWITHSTANDING BE ISSUED OR ANY MAY PERTAIN, THE INSURANCE AFFORDED F BY ANY THEO POLL IICIES DESCRIBEDO HEREIN STUB ECT TO ALLO HE WHICH TERMS, INDICATED. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID EIMS UNITS R ADDL SUBR POLICY NUMBER MPOLIC WDDIYYYY MMIDDIYYY'r 1,000,000 IrvA GENEMLLTIAILITV BIUTy INSURANCE I/ PAC0629478 11/112013 11/112014 EACH OCCURRENCE $ A DAMAGE TO RENTED 100,000 COMMERGN.GENERAL LIABILITY PREMISES Eao mence f MED EXP(Myone person) S 5'000 CLAIMS-MADE OCCUR PERSONAL 9 ADV INJURY S 1'000'000 GENERAL AGGREGATE f 3000'000 PRODUCTS-COMPIOP AGG $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ PRO- LOG COMBINED SIN LE LIMIT POLICY 11/112013 11/1=14 f 1000000 CAP0629479 Ea aLOtlenl B I AUTOMOBILE LIABILITY BODILY INJURY (Per person) f I ANY AUTO BODILY INJURY (Per accidernt S AL-OWNED, SCHEDULED PROPERTY DAMAGE AUTOS NON-0WNED ✓ HIRED AUTO✓ AUTOS Per acodani $ S S EACH OCCURRENCE f UMBRELLA LIAR OCCUR AGGREGATE S i EXCESS LIAR CLAIMS-MADE $ DED RETENTIONS Is S WORKERS COMPENSATION WC STI OR- AND EMPLOYERS' AND LIABILITY YIN TORY MITS E.L. EACH ACCIDENT $ ANVCEJUMEETORIPARTNEfUEXELUTIVE❑ NIA (Mandatory In ER E.L. DISEASE - EA EMPLOYEE S NH) IE%CLUDED] E.L. DISEASE - POLICY LIMIT f f yes des In under yes, DESCRIPTION ndonal Liaabbility lity NS DeIOw PAC0629478 1111/2013 11/1/2014 $1100010001$3,000,000 A I Professional L A Abuse & Molestation Liability PAC0629478 11/1/2013 1111/2014 $1,000,000/$3,000,000 DESCRIPTION OF OPERAPONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. ff non, space Is required) Certificate holder included as respects General Liability when required by written agreement per endorsement 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 ACCORDANCE WITH THE POLICY PROVISIONS. its officers & employees 20 E Main Street AUTHOR ZEO REPRESENTATIVE Ashland OR 97520 /I _ V"l~/~~~e DAVXae Sand L. Orr ~V-^ ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Ce0.T 50.: 1B310807 Sandy L. Orr 11/15/2013 11:15:15 aN Page 1 of 5 ORIG IMAGE COPY C Sl-03/26/09*MAC5373631-06 739929001 'D/8 0694932 GREAT AMERICAN ASSURANCE CO Administrative Offices 580 58o Waln.nut Street Cincinnati , Ohio 45202 CG 82 24 (;tiEAT,aytERjC,q/~! Tel: 1-513-369-50(10 ieeue, CECnour (Ed. 12 01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SOCIAL SERVICE AGENCY GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies _ insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 2 With respect to the insurance af- t. The fallowing provision is added to SECTION forded the Additional insured II -WHO IS AN INSURED identified in Paragraph A.(1) of this endorsement, the following 5. AUTOMATIC ADDITIONAL INSURED(S) additional provisions apply: a. Additional Insured - Manager or (a) This insurance applies only Lessor of Premises to liability arising out of the ownership, maintenance or (1) This policy amended include use of that portion of the as insured any person n or - premises leased to you. ganiz ization (hereinafter called Ad- ditional Insured) from whom you (b) The Limits of Insurance ap- lease or rent property and which plicable, to the Additional In- requires you to add such person sured are the lesser of those n organization a an Additional specified in the written con- Insured on this policy under: tract or agreement or in the (a) a written contract; or Declarations for this policy and subject to all the terms, conditions, and exclusions (b) oral agreement or con- for this policy. The Limits of tract tract where a Certificate of insurance showing that per- Insurance applicable to the Additional Insured are inclu- son or organization as an sive of and not in addition to Additional Insured has been the Limits of Insurance issued; shown in the Declarations. but the written or oral contract or - In no event shall the cov- agreement must be an "insured (c) erages or Limits of Insurance contract," and, in this Coverage Form be in- creased by such contract. (i) currently - in effect or be- come effective during the term of this policy; and (d) Coverage provided herein is excess over any other valid and collectible insurance (ii) executed prior to the "bodily injury property damage," available to the Additional In- "personal and advertising in- sued whether the other in- surance is primary, excess, jury." Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 c=flGo82ta324eoXEdana12t0`iJfr XSs/r•oto 11:15:15 M Page 2 Of s (Page 1 of 4) C • Sl-03/26/09*MAC5373631-06 739929001 *D/B ORIG IMAGE COPY GREAT AMERICAN ASSURANCE CO contingent or on any other tomarily provided by the basis unless a written con- policy forms specified in and tractual arrangement specifii- required by the contract. cally requires this insurance to be primary. (c) In no event shall the cov- erages of Limits of Insurance (3) This insurance does not apply to: in this Coverage Form be in- creased by such contract. (a) Any "occurrence" or offense which takes place after you c. Additional Insured - Contractual cease to be a tenant in that Obligations premises. (1) This policy is amended to include (b) Structural alterations, new as an Insured any person or or- construction or demolition ganization (hereinafter called Ad- operations performed by or ditional Insured) that you are re- on behalf of. the "Additional quired by a written "insured con- insured." tract" to include as an Insured, subject to all of the following b. Additional Insured - Funding provisions: Sources (a) Coverage is limited to liability (1) This policy is amended to include arising out of; as an insured any Funding Source which requires you in a written (i) your ongoing oper- contract to name the Funding ations performed for Source (hereinafter called Addi- such Additional Insured; tional insured) as an Insured but or only with respect to liability aris- ing out of your premises, "your (ii) that Insured's financial work" for such Additional Insured, control of you; or or acts or omissions of such Ad- ditional Insured in connection with (iii) the maintenance, opera- the general supervision of "your tion or use by you of work" and only to the extent set equipment leased to forth as follows: you by such Additional Insured; or (a) The Limits of Insurance ap- plicable to the Additional In- (iv) a slate or political sub- sured are the lesser of those division permit issued specified in the written con- to you. tract or agreement or in the Declarations for this policy (b) Coverage does not apply to and subject to all the terms, any "occurrence" or offense: conditions, and exclusions which took place be- for this policy. The Limits of ( ) Insurance applicable to the fore the execution of, Additional Insured are inclu- or subsequent to the sive of and not in addition to completion or expira- the Limits of Insurance tion of, the written "in- shown in the Declarations. sured contract", or (b) The coverage provided to (ii) which takes place after the Additional Insured(s) is you cease to be a ten- not greater than that cus- ant in that premises. Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 C-{a'.~GoB21824aa~ Eda_42t01+i ~VSS/2013 11:15:15 an a"ye 3 of 5 (Page 2 of 4) C S1"03/26/09•MAC5373631-06 739929001 "D/B ORIG IMAGE COPY 0694932 GREAT AMERICAN ASSURANCE CO (c) With respect to architects, work" done under a contract for that engineers, or surveyors, person or organization and included in coverage does not apply to the "products-completed operations "Bodily Injury," "Property hazard." Damage," 'Personal and Ad- vertising Injury" arising out 3. NON-OWNED OR CHARTERED WATER- of the rendering or the fail- CRAFT ure to render any profes- sional services by or for you Section I - Coverages, Coverage A, Item including: 2.g.(2) is replaced with: (i) the preparing, approv- (2) A watercraft you do not own that is: ing, or failing to pre- pare or approve maps, (a) less than 51 feet long; and drawings, opinions, re- ports, surveys, change (b) not being used to carry persons or orders, designs or property for a charge. specifications; and 4. BROADENED PERSONAL AND ADVERTISING (ii) supervisory, inspection, INJURY or engineering services. Unless "Personal and Advertising Injury" is ex- If an Additional Insured endorsement is at- cluded from this policy: lathed to this policy and specifically names a SECTION V - DEFINITIONS Item 14. is re- person or organization as an Insured, then the laced b coverage in Section II - WHO IS AN , p y: INSURED 5. Automatic Additional Insured(s) 14. "Personal and Advertising Injury" means does not apply to that person or organization. injury, including consequential "bodily in- 2. BLANKET WAIVER OF SUBROGATION jury," arising out of one or more of the following offenses: SECTION IV - COMMERCIAL GENERAL a. false arrest, detention or imprison- LIABILITY CONDITIONS, Item 8. is replaced ment; with: b. malicious prosecution; 8. Transfer of Rights of Recovery Against Others to us and Blanket Waiver of c. the wrongful eviction from, wrongful Subrogation entry into, or invasion of the right of private occupancy of a room, dwelling a. If an Insured has rights to recover all or premises that a person occupies by or part of any payment we have made or on behalf of its owner, landlord or under this Coverage Part, those rights lessor; are transferred to us. The Insured must do nothing after loss to impair them. d. oral, written, televised, videotaped, or At our request, the Insured will bring electronic publication of material, in "suit" or transfer those rights to us and any manner, that slanders or libels a help us enforce them. person or organization or disparages a person's or organization's goods, pro- b. If required by a written "insured con- ducts or services; tract", we waive any right of recovery we may have against any person or e. oral, written, televised, videotaped, or organization because of payments we electronic publication of material, in make for injury or damage arising out any manner, that violates a person's of your ongoing operations or "your right of privacy; or Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 csGGo82ie24ao~ Edo"3,2X*'k il(SS/2013 ii~is:IS nn Page 4 oe 5 (Page 3 of 4) C S1.03/26109•MAC5373631-06 739929001 •D/B ORIG IMAGE COPY 0694932 GREAT AMERICAN ASSURANCE CO f. mental injury, mental anguish, humili- Subject to 5. above, the Damage to Prem- ation, or shock, if directly resulting ises Rented to You Limit is the most we from Items 14.a. through 14.e. will pay under Coverage A for damages because of "property damage" to your g. the use of another's advertising idea in building, or to personal property of others your "advertisement"; or in your care, custody and control while at premises rented to you or temporarily h. infringing upon another's copyright, occupied by you with permission of the trade dress or slogan in your "adver- owner, arising out of any one fire. tisement." The Damage to Premises Rented To You 5. MENTAL INJURY, MENTAL ANGUISH, Limit is replaced by the following Damage HUMILIATION, OR SHOCK INCLUDED IN to Premises Rented To You Limit. BODILY INJURY DEFINITION The Damage to Premises Rented To You Section V - Definitions, Item 3. is replaced Limit is the greater of: with: (1) $300,000; or 3. "Bodily injury" means physical injury, sick- ness, or disease, including death of a per (2) the amount shown in the Declarations son. "Bodily injury" also means mental in- for Damage to Premises Rented to jury, mental anguish, humiliation, or shock You Limit. if directly resulting from physical injury, ,sickness, or disease to that person. B. This provision is subject to all the terms of SECTION III - LIMITS OF INSURANCE. 6. MEDICAL PAYMENTS C. This provision S. does not apply if Damage to Premises Rent A. The Medical Expense Limit in Paragraph 7. to You Liability of COV- ERAGE A (SECTION 1) is excluded either of SECTION III - LIMITS OF INSURANCE by is replaced by the following Medical Ex- the provisions of the Coverage Part or by endorsement. pense Limit. The Medical Expense Limit provided by 8. SUPPLEMENTARY PAYMENTS this policy shall be the greater of: A. In the SUPPLEMENTARY PAYMENTS - a. $10,000; or COVERAGES A and B provision, Item 1.b., and 1.d are replaced with: b. The amount shown in the Declarations 1.b. Up to $500 for cost of bail bonds for Medical Expense Limit. required because of accidents or traf- B. This provision 7. is subject to all the terms fc law violations arising out of the use of any of SECTION III - LIMITS OF INSURANCE. vehicle to which the Bodily In- jury Liability Coverage applies. We do C. This provision 7. does not apply if not have to furnish these bonds. ' COVERAGE C. MEDICAL PAYMENTS is t.d. All reasonable expenses incurred by excluded either by the provisions of the the Insured at our request to assist us Coverage Part or by endorsement. in the investigation or defense of the claim or "suit," including actual loss of 7. DAMAGE TO PREMISES RENTED TO YOU earnings up to $500 a day because of LIMIT time off work. A. SECTION III LIMITS OF INSURANCE, This endorsement does not change any other Item 6. is replaced with: provision of the policy. Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 cE,C-Go621a3243o3(Edaa42101+JXSs/2013 11:15:15 AN Page 5 of 5 (Page 4 of 4)