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HomeMy WebLinkAboutInsurance Certificate: Childrens Advocacy Center of Jackson Cty A r ATE (MMMDIYY YY) CERTIFICATE OF LIABILITY INSURANCE 10/29/2014 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). CONTACT PRODUCER Brown & Brown Northwest N AME: Sand L. Orr 3256 Hillcrest Park Drive PHONE 541-494-2687 A/XC No : 541-494-2787 Medford, OR 97504 MAIL ADDRESS: SOR bbnw.com INSURER(S) AFFORDING COVERAGE NAIC S www.bbnw.com INSURER A : Great American Assurance Co INSURED INSURER 8 Jackson County Child Abuse Task Force Children's Advocacy Center of Jackson County INSURER C: 816 W 10th Street INSURER D : Medford OR 97501 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 22154547 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MO! ICY EFF POLICY EXP LIMITS LTR A COMMERCIAL GENERAL LIABILITY ✓ PAC0629478 11/1/2014 11/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE T51%Wrffff_ CLAIMS-MADE E OCCUR PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 ✓ POLICY ❑ JECT 7 LOC PRODUCTS - COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY CAP0629479 11/1/2014 111/1/2015 MBINED SINGLE LIMIT $ E accident) 1,000,000 ANY AUTO I BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS j NON-OWNED PROPEcRTnDAMAGE HIRED AUTOS Lld AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE' AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N PTA TE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A ;Professional Liability PAC0629478 11/1/2014 11/1/2015 $1,000,000/$3,000,000 A ;Abuse & Molestation Liability PAC0629478 11/1/2014 11/1/2015 $1,000,000/$3,000,000 f i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Certificate holder included as respects General Liability when required by written agreement per endorsement attached. CERTIFICATE HOLDER CANCELLATION Ci of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE its officers & employees ATHE CCORDANCEIW TH THE POLICY ROVISIONSE WILL BE DELIVERED IN DATE THEREOF, 20 E Main Street Ashland OR 97520 AUTHORIZED REPRESENTATIVE Sand L. Orr ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 22154547 Sandy L. Orr 10/29/2014 4:14:21 PM. (PDT) Page 1 of 5