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HomeMy WebLinkAboutInsurance Certificate: Ashland School District #5 N CERTIFICATE OF COVERAGE DATE F 9/2/2014 AGENT THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Northwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3256 Hillcrest Park Drive HOLDER OTHER THAN THOSE PROVIDED IN THE COVERAGE Medford, OR 97504 DOCUMENT. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COVERAGE DOCUMENTS LISTED HEREIN. www.bbnw.com COMPANIES AFFORDING COVERAGE NAMED PARTICIPANT COMPANY A: Property Casual Covera a for Education Ashland School District #5 885 Siskiyou Blvd COMPANY B: Genesis Insurance Company Ashland OR 97520 COMPANY C: COMPANY D: COMPANY E: COVERAGES THIS IS TO CERTIFY THAT COVERAGE DOCUMENTS LISTED HEREIN HAVE BEEN ISSUED TO THE NAMED PARTICIPANT HEREIN FOR THE COVERAGE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE COVERAGE DOCUMENTS LISTED HEREIN IS SUBJECT TO AL L THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH COVERAGE DOCUMENTS. AGGREGATE LIMITS WHICH ARE SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, SUITS OR ACTIONS. THE TITLES REFERENCED UNDER TYPE OF COVERAGE ARE INSERTED SOLELY FOR CONVENIENCE OF REFERENCE AND SHALL NOT BE DEEMED IN ANY WAY TO LIMIT OR EFFECT THE PROVISIONS TO WHICH THEY RELATE. co EFFECTIVE DATE EXPIRATION DATE LTR TYPE OF INSURANCE COVERAGE DOCUMENT NUMBER M MMIDD LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 20,000,00 A COMMERCIAL GENERAL LIABILITY 29P60056-106 7/1/2014 7/1/2015 EACH OCCURRENCE $ 500,00 PUBLIC OFFICIALS LIABILITY V/ EMPLOYMENT PRACTICES OCCURRENCE AUTOMOBILE LIABILITY GENERAL AGGREGATE $ 20,000,000 A SCHEDULEDAUTOS 29P60056-106 7/1/2014 7/1/2015 EACH OCCURRENCE $ 10,000,000 HIRED AUTOS ✓ NON-OWNEDAUTOS AUTO PHYSICAL DAMAGE SCHEDULED AUTOS PER SCHEDULE A SCHEDULEDAUTOS 29P60056-106 7/1/2014 7/1/2015 HIRED AND NOW ✓ HIRED AUTOS OWNED AUTOS $ 100 Comp/500 Coll ✓ NON-OWNEDAUTOS EXCESS LIABILITY GENERAL AGGREGATE $ 20,000,000 A ✓ COMMERCIAL GENERAL LIABILITY 29P60056-106 7/1/2014 7/1/2015 EACH OCCURRENCE $ 9,500,00 B ✓ PUBLIC OFFICIALS LIABILITY ✓ EMPLOYMENT PRACTICES ✓ AUTO LIABILITY PROPERTY DESCRIPTION Ashland High School Homecoming Parade 9/24/2014. CERTIFICATE TYPE 1:3 EVIDENCE OF INSURANCE CERTIFICATE © ADDITIONAL PARTICIPANT CERTIFICATE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE COVERAGE DOCUMENTS HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, PACE WILL ENDEAVOR TO MAIL Clty of Ashland WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE 20 E Main Street TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY Ashland OR 97520 KIND UPON REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Sandy L. Orr CERT NO.: 21442053 Sandy L. Orr 9/2/2014 4:32:31 PM (PDT) Page 1 of 2 Applicable Coverage Document Definitions: The following definitions are provided solely for convenience of reference and shall not be deemed in any way to limit or affect the provisions to which they relate, for complete details on the terms, conditions and exclusions of applicable Coverage Documents please refer to the PACE Liability Coverage Document. Participant means: 1. The Named Participant and each of the following while acting within the course and scope of their duties as such: a. Members of the Board; b. Executive Officers; c. Employees; d. Volunteers and Agents; e. Registered Students whose course study includes on-the-job training, but only while acting under directions and within the scope of their activities performed while in training; f. Student Organizations, Parent Teacher Organizations, Booster Clubs and Foundations under the jurisdiction and supervision of the governing board; and g. Any person, entity or any organization the Named Participant is required by an Insured Contract to include as a Participant. This coverage will be limited to the extent of coverage and Limits of Liability required by the Insured Contract and will not increase the limits stated in SECTION V. - LIMITS OF LIABILITY or alter any of the terms of coverage stated in this Coverage Document. The Insured Contract must be effective and executed prior to a covered Occurrence or Wrongful Act. In no event shall coverage under this Coverage Document extend to any party for any Claim however or whenever asserted, arising out of such parry's sole negligence. (1) The term "Additional Insured" if used in an Insured Contract shall be understood to mean the same as Additional Participant. 2. With respect to: Mobile Equipment or any Auto, any person is a Participant while driving such Auto or Mobile Equipment with a Named Participant's permission. Any person, entity, or organization responsible for the conduct of such person is also a Participant, but only with respect to Bodily Injury or Property Damage arising out of the operation of the Auto or Mobile Equipment. However, the owner or anyone else from whom a Named Participant hires or borrows an Auto is a Participant only if that Auto is a trailer connected to an Auto a Named Participant owns. However, no person, entity, or organization is a Participant under this paragraph 2. with respect to: a. Property Damage to property owned by a Named Participant or the employer of any person who is a Participant under this provision; b. Any Auto a Named Participant hires or borrows from one of a Named Participant's Employees, volunteers or members of their households, if they are the owner of such Auto, unless acting within the scope of their duties on a Named Participant's behalf; c. Any Auto being used by a person employed in the business of selling, servicing, repairing, or parking Autos unless they are a Named Participant's Employees; or d. The movement of property to or from an Auto except a Named Participant, a Named Participant's Employees, lessees or borrowers of such Auto, and any employee of the lessees or borrowers. Insured Contract means: 1. A legally enforceable contract that includes one or all of the following: a. A lease of premises as it relates to tort liabilities assumed by the Named Participant arising out of the lease, such assumption occurring in writing prior to the date of Occurrence; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a Public Body; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to the Named Participant's operations (including an indemnification of a Public Body in connection with work performed by or for a Public Body) under which the Named Participant assume the tort liability of another person or entity to pay for Bodily Injury, Property Damage or Personal Injury to a third person or organization, provided the Bodily Injury, Property Damage or Personal Injury occurs subsequent to the execution of the contract or agreement; and g. Contracts for services with Public Bodies. 2. An Insured Contract does not include that part of any contract or agreement: a. That indemnifies an architect, engineer or surveyor acting as an independent contractor for injury or Damages arising out of professional errors or omissions; b. That indemnifies any person or organization for Damages by fire to premises rented or loaned to the Participant; and c. That involve the purchase or sale of real property or personal property. CERT NO.: 21442053 Sandy L. Orr 9/2/2014 4:32:31 PM (PDT) Page 2 of 2