HomeMy WebLinkAboutInsurance Certificate: Ashland Gun Club
ACO OR
E (MM/DO/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 77/16/2014
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 acr
Lockton Affinity, LLC HONE ACX
P.O. Box 410679 A/C No.Ext : 877-487-5407 A/, No):
Kansas City, MO 64141-0679 -MAIL
DDRESS:
INSURERS AFFORDING COVERAGE NAIC
NSURER-A: Certain Underwriters at Uo d's London
INSURED NSURER-B:
Ashland Gun Club NSURER-C:
P.O. Box 953, NSURER-D:
Ashland, OR 97520 NSURER-E
NSURER-F:
:
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. 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.
IN ADDL us POLICY EFF POLICY EXP
SR INSR MWDDIYYYY) MMIDD/YYYY)
R TYPE OF INSURANCE Avo
POLICY NUMBER LIMITS
A GENERAL LIABILITY X LM201444982 091052014 091,052015 EACH OCCURRENCE $1000000
DAMAGE TO RENTED
X MMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $300000
LAIMS MADE X OCCUR MED EXP A one person) $5000
PERSONAL & ADV INJURY $1000000
GENERAL AGGREGATE $2000000
EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $2000000
PRO-
JECT LACY LOC $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY Ea accdent) $
Y AUTO BODILY INJURY Per Person $
ALL OWNED SCHEDULED BODILY INJURY (Per
AUTOS AUTOS accident $
P NON-OWNED PROPERTY DAMAGE
HIRED AUTOS AUTOS Per accident $
MBRELLA LIAR OCCUR EACH OCCURRENCE $
LESS LIAR CLAIMS MADE AGGREGATE $
ED RETENTION $
ORKERS COMPENSATION C STATU- LOTH-
ND EMPLOYERS' LIABILITY CRY LIMITS R
NY PROPRIETOR/PARTNER/EXECUTIVE YIN
FFICER/MEMBER EXCLUDED? WA E.L. EACH ACCIDENT $
MANDATORY IN NH) E.L. DISEASE - EA
f es describe under EMPLOYEE $
E.L. DISEASE-POLICY
ESCRIPTION OF OPERATIONS below LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
20 E. Main St., ACCORDANCE WITH THE POLICY PROVISIONS
Ashland,OR 97520
AUTHORIZED REPRESENTATIVE
9
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
110312 Additional Insured Copy