HomeMy WebLinkAboutInsurance Certificate: Pacific Retirement Services Inc (2)
,4c Rd CERTIFICATE OF LIABILITY INSURANCE °"02"04/""°1a"'
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
IELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
PRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
Fl~ho40 PORTANT: N the certificate holder Is an ADDITIONAL INSURED, the Pollay(las) must be andomed. If SUBROGATION IS WANED, subject to
terms and conditions of the policy, certain policies may require an endoesoment. A statement on this certificate does not confer rights to the
'tlfleate holder In Ilau of such sndoreams a .
DULES CUnderwming Associate
ng Canmuni0ea Shared Services LTD
W. VAndtester Rued w 847.548-8225 (ArCNon; 847-54&8085 ES: rtyvilk it 80048 ADDRESS: Certificates®ceringcomm.org
INSURERS AFFORDING COVERAGE NAIC P
MURED Padfic RaBroment Services Inc. INSURER K Caring Communibes, A Redprocal RRG 12373
Community Volunteer Network MURER S:
1045 Elandale Drive INSURER C:
Medford OR 97504
wsuaERD
wstn E E.
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. NOTMTHSTANDING 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.
MR
MR VAQ MUD. NR1`ODh`Y1hh TYPE OF INSURANCE AWL SUER PCLJCYRUMBER POLICY OF POLICY EP Ulams
GENERAL LJAerLm CCRRRG001&14 01/01/014 01/01/015 EACH xCURRENCE s - 1000000.00
A X cOM1AERCLIL OENE LVBM1RY X DAMAGE TO RENTED
MEMISE6 acuwanm s 300,000.00
X CLAIMS MADE F-~ OCCUR MED EXP (Any me person) f
X Professional Liability PERSONALSAwINJtaiY f 1,000,000.00
X Retro Date 01/01/002
OENERKAGOREOATE $ 3.000.000.00
GENLAGDREGAMU4ITMPUESPER: PRODUCTS-COMROPAOO It Ind
X Foucv PRO- LOC s
AUTOMMU LIAPoLnY CO.BI SINSMUMIT
i
(Ee ANY AUTO
BODEV INJURY (Per peregn) f
ALL O"ED MEOULED
AUTOS S PAUTOS BODILY INJURY (PererJdmq 3
HIRED AUTOS NOfL~ONaEp PROPERTY DAMAGE f
ettWeM
i
"CESSIUMBRELLALJIIBILRY EACH OCCURRENCE i 10000000.00
A umaaeLI LIAB OCCUR X CCRRRG-0015-14 01/0112014 01/01/015
AGGREGATE s 15,000,000.00
X EXCESS UAB X CWMe MADE f
s
DEDUCTIBLE
y
RETENTION i
WORIrsRS COMPENSATION AND s
EMPLOY N-LIABRNY OC OTIL
TORY LIMITS
R
ANY MOPmETORIPARTNFA,E.XECUTNE f
OFFICERMEMBER E%CLUDED9 E1 EACH ACGDENT
Semesters In NH) E.L. USEASE-EA EMPLOYEE S
are" deerlbe under
6PECIAL PItOVISI0N8 ONOx
E.L. DISEASE - POLICY LIMR i
OT ER
A EXCESS PROFESSIONAL $$2,000,000 EACH OCCURRENCE
X CCRRRG001&14 01/01/014 01/01/015 $$2,000,000 AGGREGATE
LIABILITY FL, LA, AR SUBLIMIT (INCLUDED IN EXCESS LMTS ABOVE)
MORIP11" OF OPERATIONS I LO `Mn I VEHICLES I EXCLUSIONS ADDED BY ENDORDEMEW) SPECIAL PROWIOna
02/0412014 14:04:00
The CerOfirate Holder is included as an Additional INSURED under this POLICY but oniy with respeq tO lisbady ensing out oT servims rendered by ee Named INSURED As
oWded whin the terms and conditions of are wo atual agreement for the Foster Grandparent pnprem between the City of Ashland And the Named INSURED.
CERTIFICATE HOLDER CANCELLATION
The City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 East Maln Street ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland OR 87520
' AUTNOR~OgEP1eElFMAIIVE
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