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HomeMy WebLinkAboutInsurance Certificate: Southern Oregon Transportation DATE (MM/DD/YYYY) . C40RLY CERTIFICATE OF LIABILITY INSURANCE 3/3/2015 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 endorsements . PRODUCER CONTACT NAME: She[y] Wrts Protectors Insurance, LLC PHONE A/C No !A/C- No- Ext)a 1)842-2968 P.O. Box 4669 E-MAIL Medford OR 97504 ADDRESS INSURERS AFFORDING COVERAGE NAIC # INSURERA:Amer 0 can Casualty Company INSURED SOUTH03 INSURER B: A Continental CasuaU Co Southern Oregon Transportation INSURER C:Continental Casualty Company Engineering LLC INSURER D : 112 Monterey Dr Medford OR 97504 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 273610624 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 L UBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY B4018108107 /15/2015 /15/2016 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $300,000 CLAIMS-MADE D OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ GENERALAGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ X POLICY PRO LOC $ B AUTOMOBILE LIABILITY B4018108110 /15/2015 /15/2016 Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED L SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C E&O MCH288263850 /22/2013 /22/2016 Occurence 2,000,000 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Ashland& official, officers & Employees as additional insured per attached policy forms: For General Liability with Waiver of Subrogation & Products/Completed operations per SB300176B0108, Cancellation per SB147052 For Auto per CA2048-10-13 with Waiver of Subrogation per CA0444-03-10 30 day notice per G56015B 11-91 , Primary per CA0001-10-13 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 E Main Street Ashland OR 97502 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. 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