HomeMy WebLinkAboutInsurance Certificate: Thrive
From: Ashland Office Ni Fax: To: +15415522059 Fax: +15415522059 Page 2 of 2 0611112014 1:09
® DATE(MWDDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 6/11/2014
HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
:ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
IELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
IF-PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
VIPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
he terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
;ertificate holder in lieu of such endorsement(s).
TA Julie Asher
c0AME:
)DUCER N
Ihland Insurance Inc PHONE (541) 482-OB31 FNC. Not, (541)488-5B51
15 A Street Suite 1 EMAIL , jasher12aahlandinsurance. cam
0. BOX 880 INSURERS AFFORDING COVERAGE NAICN
Ihland OR 97520 INSURER A Alliance of Nonprofits for
AIRED INSURER B :
le Rogue Initiative For a Vital Economy, INSURER C:
3A: THRIVE INSURER O:
10 A Street Suite 205 INSURERE:
fhland OR 97520 INSURER F:
)VERAGES CERTIFICATE NUMBER:CL1461104849 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.
R POLICY NUMBER PMDCY EFF POLICY EJv LIMBS
R TYPE OF INSURANCE AD
GENERALLIAEIOTY EACH OCCURRENCE 5 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES a ommm~mi f 500,000
CLAIMS-MADE ❑X OCCUR X 014-27698 6/1/2014 611/2015 MED EXPAny one person) 5 20,000
PERSONAL S AOV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
GENL AGGREGATE WAIT APPLIES PER: PRODUCTS - COMP/OP AGG 5 2,000,000
X POLICY PRO LOC S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
IFA ANY AUTO BODILY INJURY(Parpersan) S
ALL OWNED SCHEDULED BODILY INJURY Per acddeN) S
AUTOS AUTOS
NON-OWNED PPR~OPPEERT DAMAGE S
HIRED AUTOS AUTOS id.rdl
5
UMBRELLA LIAB OCCUR EACH OCCURRENCE S
EXCESS LVIB CLAIMS-MADE AGGREGATE S
DED RETENTIONS 5
WORKERS COMPENSATION WCSTATU- OTH-
AND EMPLOYERS' LIABILITY - FIR
NIA EL EACH ACCIDENT 5
ANY PROPRIETOWPARTNERIEXECUTIVE YIN
OFFICERIMEMBER E XCLUDEDT
(Mandatory In NH) EL DISEASE-EA EMPLOYE f
III- . dasaibe under E.L DISEASE - POLICY LIMB 5
DESCRIPTION OF OPERATIONS below
ESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addillonsl Ranadu Schodula Ifmurospaco is required)
:ity of Ashland, Its officers and employees are listed as additional insured
:ERTIFICATE HOLDER CANCELLATION
541) 552-2059 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Ashland, Its officers and
employees
Bryn Morrison Finance Dept AUTHORIZED REPRESENTATIVE
20 East Main St
Ashland, OR 97520
Julie Asher/JAA
%CORD 26 (2010105) ®1959-2010 ACORD CORPORATION. All rights reserved.
NS025 (2mos)A1 The ACORD name and logo are registered marks of ACORD