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Home My WebLink AboutInsurance Certificate: Pacific Retirement Services Inc -4 CERTIFICATE OF LIABILITY INSURANCE FDA 2/26/20114"'' 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(les) 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 Caring Communities Shared Services LTD NAME: Underwriting Associate 1850 W. Winchester Road ac Nr o• Ett : 847-549-8225 I FAX "C,1,10 847-549-8095 Suite 109 E-MAIL ADDRESS: Certificates@caringcomm.org Libertyville IL 60048 INSURERS AFFORDING COVERAGE NAIC # INSURED Pacific Retirement Services Inc. INSURER A: Caring Communities, A Reciprocal RRG 12373 Community Volunteer Network INSURER B: One West Main St. INSURER C: Suite 303 Medford OR 97501 INSURER D: INSURER E: 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. INSR TYPE OF INSURANCE ADD'L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDD (MMfDDAYM GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 A X COMMERCIAL GENERAL LIABILITY X CCRRRG-0015-15 01/01/2015 01/01/2016 DAMAGE TO RENTED X CLAIMS MADE OCCUR PREMISES Ea occurrence $ 300,000.00 MED EXP (Anyone person) $ X Professional Liability PERSONAL b ADV INJURY $ 1,000,000.00 X Retro Date 01/01/2002 GENERAL AGGREGATE f 3,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG f incl PRO- LOC $ X POLICY F-1 JF AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f Ea accident ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS NON-OWNED PROPERTY DAMAGE H - I AUTOS Per accident f f EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000.00 A UMBRELLA LIAB X CCRRRG-0015-15 01/01/2015 01/01/2016 AGGREGATE f 15 000 000.00 X EXCESS LIAB ROCCUR CLAIMS MADE f S DEDUCTIBLE E RETENTION $ f WORKERS COMPENSATION AND WC STA.TL'- OTH- EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 12/26/2014 10:57:54 The Certificate Holder is included as an Additional INSURED under this POLICY but only with respect to liability arising out of services rendered by the Named INSURED as outlined within the terms and conditions of the contractual agreement for the Foster Grandparent program between the City of Ashland and the Named INSURED. CERTIFICATE HOLDER CANCELLATION The City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 East Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Ashland OR 97520 AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD