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HomeMy WebLinkAboutInsurance Certificate: ACCESS (2) A`C CERTIFICATE OF LIABILITY INSURANCE DATE ?/2MNdYYYY) 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 poliey(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 Hen of such endorsement(s). CONTcr PRODUCER Brown & Brown Northwest N AME: Sand L. Orr 3256 Hillcrest Park Drive PHONE FAX Pe-Exit- 1 Medford, OR 97504 541-494.2687 ac No: 541.494-2787 DRESS. sorr@bbnw.cwm _ INSURE) I AFFORDING COVERAGE NAIC9 vnw+.bbnw.com INSURER A: Philadelphia Indemnity Insurance CO 18058 INSURED INSURERS: ACCESS; Conifer Gardens Limited Partnership; Access Development Corporation INSURERC: 3630 Aviation We INSURER D: Medford OR 97504 INSURER E: f INSURER F: i COVERAGES CERTIFICATE NUMBER: 20719677 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. ILSR TYPE OF INSURANCE POLICYNUMBEft MWDOYEFF P DU EXP LIMITS HIED VVVD A COMMERCIALGENERALLIABILITY PHPK1194667 7/1/2014 7/112015 EACHDCCURRENCE $ 1,000,000 CLAIMS-MADE © OCCUR PREMISES (Eaccoverxo) n S 100,000 MEDEXP M ore efaon $ 5.000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAI.AGGREGATE S 2,000,000 ✓ POLICY 0 JEC ❑ LOC PRODUCTS-OOMPA)PAGG S 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY PHPK1194667 7112014 7/112015 COMBINED IEP I LIMIT s 1000000 UTOS 0 ED SCHEDULED BODILY INJURY(Per acNdeni) S 1/1,OPHDrehensiv AUTO GOOILY INJURY(Per person) S A' HIREDAUTOS NONNNED PPRNPEaRTY DAMAGE $ AUTOS Coliislon Deductibles $ $500/$1,000 A UMBRELLA LIAR OCCUR PHUB464147 7/1/2014 711/2015 EACH OCCURRENCE $ 5000000 i EXCESS LIAR CLAIMS MADE AGGREGATE S 5.000,000 DED RETENTION 1B,BOB $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN I PTA ER ANYPROPRIETORIPARTNER XECUITVE E.L.EACHACCIDENT $ OFFICERIMEMBER EXCLUDED? E] NIA (Mandatory In NH) E.L. DISEASE EA EMPLOYE $ Ii yyas dOetllOe Uocef OEGdRIPTIONOFOPF.RATIONSbebw E.L. DISEASE POUCY LIMIT S A Blanket Buildings - $1,000 Ded. PHPK1194667 7/112014 7112015 Per Occ/Aggregale $2,000,000 Blanket BPP - $1,000 Ded PHPK1194667 7/1/2014 7112015 315,974,270 Agreed Value Directors & Officers Liability PHS09452041 7112014 7112015 $824,850 Replacement Cost DESCRIPTION OF OPERATIONS) LOCATIONS$VEHICLES (ACORD 101, AddlDosal Remarks Schedule, may no attached It more space is requVae) CERTIFICATE HOLDER CANCELLATION ANY OF RA70NHDATEVTHE EOF,ENOTICEIEWIBLCBECDELIVERED BEFOREIN City of Ashland THEUEXPI 20 E Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE Sand L. Orr ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORDIname and logo are registered marks of ACORD CORP IA.: 20719607 sandy L. Oar 4/27/2014 5,03:13 eN (Por) Page I of 1