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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