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HomeMy WebLinkAboutInsurance Certificate: Southern OR Film & Television A`~ °O® CERTIFICATE OF LIABILITY INSURANCE 7/l/2014 ) 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(ies) 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 endorsement(s). PRODUCER CONTACT Teresa Bena NAME: JD Fulwiler S Co Insurance Inc PHONE ,,.(503)293-8325 ac o: (503)293-5418 5727 SW Macadam Ave ADDRESS: then@jdfulwiler.com PO BOX 69508 INSURER(S) AFFORDING COVERAGE NAIC9 Portland OR 97239 INSURER A: Ohio Security Insurance Co 24062 INSURED INSURER B: INSURER C : Southern Oregon Film and Television (SOFaT) INSURER D: PO Box 1265 INSURER E: Ashland OR 97520 INSURER F: COVERAGES CERTIFICATE NUMBER: 2014 GL HNOA 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 A L U POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MWDD/YYYY LIMITS GENERAL LIABILITY _ EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES TURENTED IS 1,000,000 Fx~ A CI-AIMS-MADE OCCUR, BKS1556165730 6/7/2014 6/7/2015 MED EXP(Any one person) $ 15,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaamitlent INCLUDED ANY AUTO BODI LY I NJURY(Pw person) $ A ALL OWNED SCHEDULED BKS1556165730 6/7/2014 6/7/2015 BODILY INJURY (Pm amident) $ AUTOS AUTOS X HIRED AUTOS X NO2SWNED PROPERTY DAMAGE S S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTIONS S WORKERS COMPENSATION WC STATU- OTH-TORY LIMIT ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) The City'of Ashland, Its officers and employeesare added as additional insureds but only as respects operations of the named insured in accordance with the policy terms, conditions S exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Bryn Morrison Finance Dept, 20 East Main St AUTHORIZED REPRESENTATME Ashland, OR 97520 Teresa Bena/TBENA ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INBn25,,n,,,nsl n, Trio Acntan n~.ne enrl Innn ire runiehnrnd n .,Ie. M Arnwn